Progress in hepatic diabetes.docVIP

 PAGE \* MERGEFORMAT 11 Progress in hepatic diabetes [Keywords:] liver diabetics Diabetes is a chronic hepatic parenchymal liver damage caused impaired glucose tolerance, diabetes, some patients eventually develop into [1]. Most scholars believe that about 50% to 80% of chronic liver disease patients with impaired glucose tolerance, 20% to 30% final the development of diabetes. The normal population is only 0.6% incidence of diabetes, various types of hepatitis in China, higher incidence of cirrhosis of the liver by chronic hepatitis and cirrhosis of the liver caused by impaired glucose tolerance or diabetes is not rare, timely diagnosis and proper treatment abnormal glucose metabolism for the effective treatment of chronic liver disease and improved patient outcomes are very important. 1 Pathogenesis The occurrence of diabetes, hepatic insulin resistance and secretion in progressive damage to the common result. Pathogenesis is not fully understood at present, may be related to the following factors. 1.1 when the liver cell membrane insulin resistance in liver insulin receptor on the reduction in the number of insulin receptors and reduced affinity, to insulin by reducing, not achieve the effect of regulating glucose metabolism, and insulin metabolism in the liver and the activity of enzymes related to low glucocorticoid antagonist of insulin, glucagon, growth hormone and free fatty acids decrease hepatic inactivation of the plasma concentration increased, the surrounding tissue to promote resistance to insulin, causing blood sugar. 1.2 The doctrine of insulin sensitivity in patients with cirrhosis most of the low presence of hyperinsulinemia. Most studies show that: fasting insulin levels and insulin sensitivity index has good correlation. Zhangling Deng [2] show that: cirrhosis of the liver glucose metabolism abnormal insulin sensitivity index was significantly lower than normal, and worse liver function, higher incidence of diabetes. 1.3