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Abstract
Background
Liver cirrhosis is associated with profound metabolic derangements due to impaired hepatic glucose regulation. Hypoglycemia has an underappreciated complication, although it has the potential clinical consequences, while hyperglycemia and diabetes are well known. Data, particularly from developing countries, regarding the burden of hypoglycemia among patients of liver cirrhosis, is limited.
Objective
To determine the frequency of hypoglycemia among patients with liver cirrhosis presenting to a tertiary care hospital.
Methods
This cross-sectional observational study was conducted on adult patients presenting to a tertiary care hospital aged 28 to 70 years old with clinically, biochemically, and radiologically confirmed liver cirrhosis in the Department of General Medicine at Medical Teaching Institution Mardan Medical Complex, over a time period of six months. Blood glucose levels were tested immediately at presentation or measured within 24 hours of admission by using standardized methods. Blood glucose level below from70 mg/dL were defined as Hypoglycemia. Child–Pugh class and MELD score. The Demographic and clinical variables were also recorded during the study. Descriptive statistics were used to summarize results, and chi-square tests were applied to find the relation between hypoglycemia and selected clinical variables. All the data were analyzed using SPSS version 27.
Results
A total of 151 patients with confirmed liver cirrhosis were included, with a mean age of 51.3 ± 9.4 years; 36.8% female and 64.2% were male. In 77 patients with the overall frequency of 51.0% hypoglycemia was observed in 77. The rise in percentage of hypoglycemia is observed with advancing liver disease severity, occurring more commonly in Child–Pugh class C compared with classes A and B; but this association had no statistical significance (p = 0.232). No prominent linkage was found between hypoglycemia and residential background, sex or diabetes mellitus status.
Conclusion
Hypoglycemia affected almost half of the studied population and was recognized as a common metabolic abnormality among confirmed liver cirrhosis patients presented to the Medical Teaching Institution, Mardan Medical Complex. Hypoglycemia occurred across all stages of cirrhosis, with which it was more common in advanced liver disease. These study findings highlight the significance of regular glucose measurement in patients with liver cirrhosis to promote early diagnosis in patients and appropriate clinical management.