Liver disease in patients with diabetes mellitus.

Liver function tests were assessed in 60 unselected out-patient diabetics stabilized on insulin or oral hypoglycaemic agents. Routine liver function tests, particularly plasma concentrations of gamma-glutamyl transpeptidase and alkaline phosphatase were elevated occasionally but rarely to more than twice the upper limit of normal. There was no correlation between measures of diabetic control and results of liver function tests. Twelve (20%) patients had evidence of gall stones, a prevalence above the expected from the community. Fourteen (23%) patients had an abnormally bright liver ultrasound echo pattern, probably indicative of fatty infiltration of the liver. This echo pattern was associated with only a minimal rise in plasma alanine amino transferase and alkaline phosphatase concentrations. It is concluded that functionally significant liver disease is uncommon amongst stabilized diabetic patients.