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Subject Area

Clinical Pathology

Article Type

Original Study

Abstract

Objective To study the impact of diabetic microangiopathy on the outcome of cirrhotic patients with variceal bleeding. Background There are various risk factors for variceal bleeding in cirrhotic patients such as diabetes mellitus, and so follow up of these patients to determine the effects of diabetic microangiopathy on presentation, course, and mortality is mandatory to improve the plane of care. Patients and methods This study is an observational–analytic case–control hospital-based study, which was conducted on 60 patients admitted with acute variceal bleeding. Based on the WHO criteria of diabetes mellitus, the patients were divided into three groups. Group I: 20 diabetic cirrhotic patients with microvascular complications, group II: 20 diabetic cirrhotic patients without microvascular complications, and group III: 20 cirrhotic patients only. All patients were subjected to: full history, clinical examination, complete blood count, liver functions, kidney functions, fasting and 2 h postprandial blood glucose, glycated hemoglobin, vascular endothelial growth factor assay, abdominal ultrasound, fundus examination, monofilament test, and upper gastrointestinal endoscopy. Results The results showed that the mean frequency of rebleeding attacks was significantly higher in group I than other groups and the mean length of hospital stay was significantly higher in group I than other groups. The mortality rate during the period of follow-up was higher in group I than other groups. Conclusion The study showed that cirrhotic patients with diabetic microangiopathy are associated with increased risk of rebleeding esophageal varices, multiple admissions to hospital, long hospital stay, and mortality rate higher than other patients.

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