Mahesh Kumar, Safia Bano, Kabira Memon, Prem Chand, Muhammad Muneeb & Aatir H. Rajput
Background: Alterations in carbohydrate metabolism are frequent in cirrhosis, the prevalence being dependent of the stage of the disease. In 15% to 30% of patients the clinical and laboratory picture is that of overt diabetes with fasting hyperglycemia and frank glycosuria. Diabetes follows cirrhosis in approximately 50% of patients with associated diseases, but the two conditions may be simultaneously diagnosed, or cirrhosis may even follow diabetes. The association is clinically relevant and merits attention. Objective: To study the prognostic efficacy of glycemic control in patients with HBV & HCV related cirrhosis presenting with co- morbid diabetes mellitus. Methodology: This retrospective analysis was conducted using hospital records of 374 patients admitted to a tertiary care hospital with HBV & HCV related cirrhosis presenting with co-morbid diabetes mellitus from January 2018 to December 2018. No gender or age related bias was observed and all records were chosen via non-probability consecutive sampling. Data was recorded onto a structured questionnaire containing inquiries about the glycemic control history (prior to admission and during hospital stay), the viral load kinetics (at presentation and discharge), self-rated symptom severity, inferences obtained from clinical examination notes at presentation and discharge and details of all morbidity and mortality during hospitalization. The data obtained was analyzed using SPSS v.21 & Microsoft Excel 2016.Results: Among, the patient records obtained, 59.09% belonged to men, while the remaining 40.91% belonged to women. The mean age of the sample stood at 47.63 (SD ± 8.1). Among the subjects, poor glycemic control was common found, being particularly worse in patients with a high viral load and a longstanding history of cirrhosis. In-hospital mortality rate in the sample was 18.98%.Conclusion: After careful consideration, it can be concluded that eventual glycemic control has a lot of potential to be used as aprognostic indicator as is evident from our finding that mortality rate and glycemic control align well together. Further prospective research is needed to cement this prognostic association. Keywords: HBV, HCV, Diabetes Mellitus, Cirrhosis and Prognosis.