Frequency of undiagnosed Diabetes Mellitus in patients of Non Alcoholic Fatty Liver Disease: An observational cross sectional study at a tertiary care centre of Sub-himalayan Region

Background: Most individuals with NAFLD have insulin resistance but not necessarily overt glucose intolerance .Present study was done to describe the frequency of undiagnosed diabetes mellitus in patients of non alcoholic fatty liver disease at IGMC Shimla. Material & Methods: This was a hospital based observational cross-sectional study conducted during November 2017 to November 2018 in the Department of Medicine and Radiology, IGMC Shimla. Data was entered on MS Excel spreadsheet. Results were summarized in tables and percentages. Quantitative data was summarized using means +/- & standard deviation. Cross tabulation with outcome variable of interest was done using statistical SPSS software version 22.0 . Results: Total of 100 cases, ultrasonographically diagnosed as NAFLD were included in this study. Mean age of the cases was 51.59±11.44 years. The mean fasting blood glucose (mg/dl) was 116.59±73.64, mean HbAIC was 7.31±13.48. Mean serum cholesterol (mg/dl) was 192±28.27, mean serum triglyceride (mg/dl) was 169.729±1.01, mean serum HDL (mg/dl) was 40.786±.36 and mean serum LDL (mg/dl) was 111.86±28.79. 13(13%) patients were hypertensive. 14(14%) patients had diabetes mellitus. Out of 14 total diabetic patients, 85.71% were females and 14.28% were males Impaired fasting glucose were found in 45(45%) of patients. Increased serum Cholesterol level were seen in 46(46%) patients. Increased serum triglyceride level was seen in 60(60%) patients. Low serum HDL level was seen in 88% patients. Increased serum LDL levels were 31% of patients. Percentage of diabetic patients increased as grade of fatty liver increased i.e. 9.30%, 14.30% and 75% in grade I, II, III respectively. All grade III fatty liver patients had increased triglyceride level i.e. 4(100%) while 32 (76.2%) of grade II and 24(44.4%) of grade I patients were having increased triglyceride levels Conclusion: Our study revealed that there is higher prevalence of various components of metabolic syndrome in the patients of NAFLD.