Sodexo
Allentown Internship
The Summary for Patients is
intended for patients to
better understand the
complicated and often
mystifying language of
modern medicine.
Summaries for Patients are
presented for informational
purposes only. These
summaries are not a
substitute for advice from
your own medical provider.
If you have questions about
this material, or need
medical advice about your
own health or situation,
please contact your
physician.
Summary for Patients
The Importance Of Screening Children With Type 1
Diabetes For Liver Disease
What is the problem and what is known about it so far?
The incidence of liver disease among people with diabetes is a potential complication. Fatty
liver and enlarged liver are the two types of liver diseases seen in people with diabetes.
Obesity is common in many people with type 2 diabetes and is a risk factor for liver disease.
One study showed that people with type 2 diabetes were three times as likely to have fatty
liver disease than people with type 1 diabetes. Researchers of this study wanted to work with
children who had diabetes and no other diseases or risk factors to learn more about it’s link
to liver disease.
Why did the researchers do this particular study?
Liver disease is often associated with poor control of diabetes management. The goal of the
study was to determine the incidence of liver disease in children with type 1 diabetes and see
how blood sugar affects its prevalence.
Who was studied?
One hundred and six children with diabetes type 1 were studied from November 2008 to
November 2009. Ages ranged from 8 months to 15 ½ years old. Of the 106 participants, 62
were female. All participants came from a diabetes clinic from which the name was not
disclosed.
How was the study done?
The full report is titled
"Prevalence of hepatopathy
in type 1 diabetic children."
It is in the 16 October 2012
issue of BMC pediatrics
(volume 12 page 160).
The authors are A. AlHussaini, N. Sulaiman, M.
Alzahrani, A. Alenizi and M.
Khan.
This summary was written
by Lauren Withers,
Sodexo Dietetic Intern
And was reviewed by
Robert Zurfluh RDN, and
Alison Reyes, MS, RD,
October 2013
Study participants were asked to fill out a questionnaire with their parents to collect diabetes
history. Height, weight, body mass index (tool used for body fat based on height and weight)
were recorded. Blood was collected for liver function, hemoglobin A1C (HbA1C) and a fasting
lipid (fat) profile. HbA1C >10 was considered poor diabetes management. Participants
underwent liver ultrasounds to scan for fatty or enlarged liver disease. Those presenting with
fatty or enlarged liver and elevated liver enzymes had biopsies taken of their liver. Over the
year long study period, children diagnosed with fatty or enlarged liver met with an
endocrinologist (Diabetes Specialist) and dietitian who counseled them on the importance
following a healthy diet and of achieving better diabetes control. Follow-ups were provided
at 3 and 6 months for diet compliance, HbA1C and repeat liver ultrasound.
What did the researchers find?
Researchers found that 22 of the participants showed abnormal liver ultrasounds; 10 with
enlarged liver and 12 with fatty liver disease. At 6 months follow-up, 6 participants with
enlarged liver and 7 participants with fatty liver disease showed normal liver ultrasound. This
had been achieved through adherence to a healthy diabetic diet and better diabetes
management. Participants not following a diabetic diet persisted with liver disease and their
HbA1C worsened.
What were the limitations of the study?
The biggest limitation of this study was the small sample size of participants. The results of
the study seem intriguing, although no statistical significance can be drawn. Another study
including many more participants is needed to draw significance for the general population.
What are the implications of the study?
The results of this study indicate that type 1 diabetes related liver disease is not uncommon.
Parents of children with type 1 diabetes should talk to their doctors about getting screened
for liver disease through a liver ultrasound. Early diagnosis and better diabetes management
at a young age could possibly reverse liver disease.