• Hiroko Takaike, Yasuko Uchigata, Yasuhiko Iwamoto, Akihisa Imagawa, Hiromi Iwahashi, Azuma Kanatsuka, Eiji Kawasaki, Tetsuro Kobayashi, Akira Shimada, Ikki Shimizu, Taro Maruyama, Toshiaki Hanafusa, and Hideichi Makino.
• Diabetes Center, Tokyo Women's Medical University, Japan. hirokok@dmc.twmu.ac.jp
• Ann. Med. 2008 Jan 1; 40 (5): 395-400.

Background AimsA mild increase in liver enzyme levels is sometimes observed in patients with diabetic ketosis or ketoacidosis. The aim of the present study was to assess the cause and prevalence of the elevation of liver transaminase levels in fulminant and acute-onset type 1 diabetic patients experiencing diabetic ketosis or ketoacidosis.MethodsWe analyzed data on the liver transaminase levels of 108 patients over 18 years of age with newly diagnosed type 1 diabetes complicated by ketosis or ketoacidosis. The data were collated from a nationwide survey on fulminant type 1 diabetes and retrospective medical records.ResultsThirty-two (60.4%) out of the 53 patients suffering from fulminant type 1 diabetes were detected with transient elevation of liver transaminase (TELT) levels during the first month after initiation of insulin therapy; in the case of acute-onset type 1 diabetes, such an observation was noted in 16 (29.1%) out of 55 patients. Fatty liver was diagnosed in 20% of the patients, and 65% of these patients exhibited TELT. The dosage of insulin injected in these patients was significantly high.ConclusionsHigh blood glucose and fatty liver may influence the elevation of liver transaminase levels during the treatment of new-onset type 1 diabetes.

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