Nationwide survey to compare the prevalence of transient elevation of liver transaminase during treatment of diabetic ketosis or ketoacidosis in new-onset acute and fulminant type 1 diabetes mellitus.
OBJECTIVE
A mild increase in liver enzyme levels is sometimes observed in patients with diabetic ketosis or ketoacidosis. The aim of the present study was to assess the cause and prevalence of the elevation of liver transaminase levels in fulminant and acute-onset type 1 diabetic patients experiencing diabetic ketosis or ketoacidosis.


METHODS
We analyzed data on the liver transaminase levels of 108 patients over 18 years of age with newly diagnosed type 1 diabetes complicated by ketosis or ketoacidosis. The data were collated from a nationwide survey on fulminant type 1 diabetes and retrospective medical records.


RESULTS
Thirty-two (60.4%) out of the 53 patients suffering from fulminant type 1 diabetes were detected with transient elevation of liver transaminase (TELT) levels during the first month after initiation of insulin therapy; in the case of acute-onset type 1 diabetes, such an observation was noted in 16 (29.1%) out of 55 patients. Fatty liver was diagnosed in 20% of the patients, and 65% of these patients exhibited TELT. The dosage of insulin injected in these patients was significantly high.


CONCLUSIONS
High blood glucose and fatty liver may influence the elevation of liver transaminase levels during the treatment of new-onset type 1 diabetes.
Takaike
Hiroko
H
Diabetes Center, Tokyo Women's Medical University, Japan. hirokok@dmc.twmu.ac.jp
Uchigata
Yasuko
Y
Iwamoto
Yasuhiko
Y
Imagawa
Akihisa
A
Iwahashi
Hiromi
H
Kanatsuka
Azuma
A
Kawasaki
Eiji
E
Kobayashi
Tetsuro
T
Shimada
Akira
A
Shimizu
Ikki
I
Maruyama
Taro
T
Hanafusa
Toshiaki
T
Makino
Hideichi
H
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy*; D016883:Diabetic Ketoacidosis / Q000188:drug therapy / Q000503:physiopathology*; D004305:Dose-Response Relationship, Drug; D005234:Fatty Liver / Q000150:complications; D005260:Female; D006306:Health Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007564:Japan / Q000453:epidemiology; D008099:Liver / Q000201:enzymology*; D008111:Liver Function Tests; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies
D007004:Hypoglycemic Agents; D007328:Insulin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase