Teens with diabetes and compensated cirrhosis of the liver

[mare1972]

Hello- I have a 16 year old son with type 1 diabetes. He was diagnosed at age 6.  What we found in our years of him growing.. there was plenty of times that his blood sugars would seem to be in control and other times we felt like we were on a rollercoaster. One thing is certain, when children are going through a growth spurt, the growth hormone can suppress the effectiveness of the insulin. Therefore, we noticed during peaks of growth that we would have to increase the insulin required for a length of time and then decrease it once the growth spurt was over. My son was prescribed metformin on top of his insulin regime to try to reduce the extreme amounts of NPH he was taking. He took the metformin for about 3 years and recently discontinued it in Oct 2007 because he has been diagnosed with compensated cirrhosis of the liver. And now that I have done tons of research, I have found that certain liver diseases can also cause insulin resistance. So, now I wonder.. during the times of my son's life when his insulin needs increased dramatically... were those times of liver inflammation? We haven't found the cause of the cirrhosis because there is no active inflammation. We've done a bone marrow biopsy first because my son was extremely anemic and it turned out that his marrow was somewhat iron depleted. He has an enlarged spleen, portal hypertension, hypersplenism and varices.  Portal pressure of 15. Our doctor has told us to be on the lookout for any kind of variceal bleeding because it could be a life or death situation. *scary thought* but it may or may not ever happen...
Our GI is thinking that it could be autoimmune hepatitis. I never knew that even existed! But apparently I have heard that once you have one autoimmune disease the chances of you getting another are higher.

Is there anybody else going through liver problems/cirrhosis that has type 1 diabetes? How long does compensated cirrhosis last? Just did a MRCP waiting for results. Suggestions? reading?

[JDRF Volunteer SG]

Yes, if a person is diagnosed with one autoimmune disease, others tend to show up more often than in the healthy population. So your son's doctor's idea about the hepatitis does make sense. I found a good website with lots of info about this kind of hepatitis:
ttp://www.diabetesmonitor.com/b386.htm

If this is indeed the diagnosis and your son is started on prednisone, do read up on the long-term side effects of prednisone. My twin was put on prednisone when her adrenal glands stopped producing cortisone for a period of time because of the autoimmune issues that caused both of us to become type 1 diabetics. At some point, her adrenal glands started working again, although spottily, and she was taken off of prednisone. But the weaning off of this drug takes a long time, and there are withdrawal symptoms for months after removing the drug. Very bad side effects, too, in my sister's case. So do discuss this medication and any other options fully before agreeing to treatment with prednisone. Best to be fully aware of all possible side effects. In my twin's case, the prednisone altered her digestive tract's chemical balance so that she has stomach problems now. But it can be a miracle drug when it is needed.  

[torrem]

I have been diabetic T1 for 39 yrs since I was 10.  At 12, I developed the same problems as your son although my liver became enrlarged and I was jaundiced.  At the time, I was diagnosed with chronic persistent hepatitis.  I believe that they call it now autoimmune hepatitis.  At the time, I had a biopsy and it showed scarring.  I had another bout at 17 yrs of age  but I haven't had one since.  My liver has always been tender.

I don't know what to tell you because treatments and diagnosis have changed so much since I had hepatitis.  But, what you are describing sounds so familiar to me and I have my records from that time and it describes the same issues.  My sugars were really out of control when I was sick and it was hard to treat because the prescribed treatment  for hepatitis (prednisone/cortisone) affects the sugar levels too.  The liver is an amazing organ that regenerates itself.  I don't know if your son's condition is reversible, but keep your hopes high.

I would be concerned with your sons state of mind now because it can be really depressing and scary to go through what he is going through.

Hope this helps.  Keep me posted as to his well being.

Marie

[torrem]

I have been diabetic T1 for 39 yrs since I was 10.  At 12, I developed the same problems as your son although my liver became enrlarged and I was jaundiced.  At the time, I was diagnosed with chronic persistent hepatitis.  I believe that they call it now autoimmune hepatitis.  At the time, I had a biopsy and it showed scarring.  I had another bout at 17 yrs of age  but I haven't had one since.  My liver has always been tender.

I don't know what to tell you because treatments and diagnosis have changed so much since I had hepatitis.  But, what you are describing sounds so familiar to me and I have my records from that time and it describes the same issues.  My sugars were really out of control when I was sick and it was hard to treat because the prescribed treatment  for hepatitis (prednisone/cortisone) affects the sugar levels too.  The liver is an amazing organ that regenerates itself.  I don't know if your son's condition is reversible, but keep your hopes high.

I would be concerned with your sons state of mind now because it can be really depressing and scary to go through what he is going through.

Hope this helps.  Keep me posted as to his well being.

Marie

[kodi693]

Sir,
   I am suffering with diaetic problem and alsoheart problem last 10 years  surgar range fbs 150mg/dl  pps 209 mg/dl.  I taken Human Mixstard insulin 16units morning and evening and also tab.Glyciphace 5500mg one tds  Sugar asrrange is not come to normal. What I am do?  Please give me suggestions
Thanking you Sir

Yours Sincerely
k.gangaraju
visakhapatnam
andhra prsdesh
India.

[JDRF Volunteer SG]

How is your overall weight? It sounds as if you may be dealing with some insulin resistant issues since you are taking oral meds. If you are even slightly heavier than you should be, losing weight might help you a lot, and this might help relieve stress on the heart, too. We volunteers are not doctors, so can only give suggestions from what we know from personal experience or from our own reading, so I would suggest that you go back to your doctor and insist that he help you lower those glucose levels. Our doctors  need to know that we are not satisfied with poor glucose control -- if we tell them we are not satisfied, they will often make adjustments.