Frequency of Hypoglycemia in Cirrhotic Patients Undergoing Endoscopy

TL;DR

This study finds that nearly half of cirrhotic patients experience hypoglycemia before endoscopy, highlighting the need for careful glucose monitoring in this vulnerable group.

Contribution

The study reports a 48% hypoglycemia frequency in Child-Pugh C cirrhotic patients before endoscopy, emphasizing risk factors like disease duration.

Findings

48% of cirrhotic patients had hypoglycemia before endoscopy after 6 hours of fasting.

Hypoglycemia was significantly associated with longer disease duration and Child-Pugh class C severity.

Males made up 67.4% of the study population with cirrhosis.

Abstract

Background: Liver cirrhosis is the replacement of normal liver parenchyma by fibrous tissue and nodularity. Cirrhosis liver has a negative effect on the body’s ability to regulate blood glucose levels because the liver cannot release the amount of glucose it would ultimately cirrhotic patients are at risk of hypoglycemia.

Objective: To determine the frequency of hypoglycemia in cirrhotic patients just before endoscopy after being nil per mouth (NPO) for 6 hours.

Methodology: This cross-sectional study was done at the Department of Gastroenterology Lady Reading Hospital, Peshawar from 1st April 2023 to 30th September 2023. Patients aged > 20 years of both genders, having Child-Pugh class C cirrhosis, and undergoing upper gastrointestinal (GI) endoscopy were enrolled in the study while patients with a history of diabetes using oral or parenteral hypoglycemic medications, patients taking steroids, patients with hepatocellular carcinoma and patients with hepatic encephalopathy were excluded. Diagnosis of liver cirrhosis was based on clinical examination, serum albumin level, and prothrombin time followed by characteristic findings on ultrasound. Serum glucose level was determined in the blood sample of the patient from the hospital laboratory.

Results: One hundred and ninety-six patients were enrolled including 130 (67.4%) males and 66 (32.6%) females. Age of the patients ranged from 20 to 60 years. The mean age of the participants was 46.68±10.239 years. Hypoglycemia was found in 48% of patients with liver cirrhosis. A significant association of hypoglycemia was found with disease duration and Child-Pugh class.

Conclusion: Hypoglycemia is a frequent finding in patients with liver cirrhosis and needs urgent management to prevent complications. Prolonged illness and patients with Child-Pugh class C cirrhosis are more likely to have hypoglycemia.