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KMID : 0870419980020010103
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
1998 Volume.2 No. 1 p.103 ~ p.107
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Reversible Diabetes Mellitus due to Obstructive Jaundice
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Kim Young-Woo
Han Ho-Seong
Choi Yong-Man
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Abstract
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Background: There haute been few reports showing direct correlation between obstructive jaundice and diabetes mellitus (DM). We were able to incidentally observe the reversal of DM to normal glucose metabolism after relieving obstruction of bile duct in our patients. So, we present our cases and speculate on the pathophysiology of this phenomenon.
Methods: Four patients showed reversible DM due to obstructive jaundice from August 1993 to June 1997. We reviewed their medical records retrospectively. We ruled out other causes of glucose intolerance such as primacy DM, sepsis, previous history of chronic liver disease, previous history of chronic pancreatitis, etc.
Results: The first patient was a sixty-year-old male presenting obstructive jaundice due to distal bile duct cancer. The second patient was a 53-year-old female developing jaundice due to common hepatic duct stricture after laparoscopic choloecystectomy. The third patient was a 68-year old male with pancreas head cancer and glucose intolerance. The fourth Patient was a 54-year-old male also developing jaundice due to common hepatic duct stricture after laparoscopic cholecystectomy. Insulin was necessary to maintain normal serum glucose level for two to three weeks postoperatively After being relieved of jaundice ,all patients showed normalized serum glucose levels.
Conclusion: Our study suggests that obstructive jaundice itself may cause DM. So, glucose intolerance may be a useful indicator of diseases causing obstructive jaundice. However, the pathophysiology of DM with obstructive jaundice has not yet been clarified. Further studies are needed to determine the relationship.
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KEYWORD
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Obstructive jaundice, Diabetes mellitus
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