Journal of the Asian Medical Students Association
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Type 2 Diabetes Mellitus and Alcoholic Liver Disease: a literature review
Get PDFIntroduction
Alcoholic liver disease (ALD) and type 2 diabetes mellitus (T2DM) are two important chronic diseases in Australia, both of which are emerging epidemics. As a result, patients presenting with both conditions may become increasingly more common. However, not much is known about how each affects the other in terms of clinical outcomes.
Methods
Evidence from studies exploring the relationship between T2DM and ALD, including those pertaining to liver function tests (LFT) and hepatocellular carcinoma (HCC), was reviewed and summarised.
Results
There are studies which show that high alcohol intake and chronic liver disease (CLD) are risk factors of developing T2DM. Conversely, having impaired glucose tolerance has been shown to promote progression of CLD. There is also some evidence of increased risk of HCC in patients with T2DM and who consume alcohol in the context of other liver disease. However, no studies that looked into how T2DM directly affects LFT results in ALD were found.
Discussion
There seems to be a bidirectional relationship between T2DM and ALD, although it is not explicitly cause-and-effect in nature. Hence, there is a need for a comprehensive management plan that utilises a multidisciplinary approach to minimise the risk of complications for patients with either or both diseases. Currently, this is not available and both diseases are treated as separate entities. Therefore, further research must be done to elucidate the relationship between the two, so that effective strategies to manage co-existing T2DM and ALD can be developed
Ulinastatin as a Potential Alternative Therapy for Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis
Get PDFStevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) is an emergency skin disease with high mortality rates despite the incidence rate is not great. Patients with SJS/TEN will experience reduced quality of life due to the pain experienced when eating, drinking or urinating. There is not a specific treatment for patient with SJS/TEN so far. Corticosteroids and intravenous immunoglobulin (IVIG) are the most commonly used therapies yet there are still controversies due to their positive and negative effects. Ulinastatin, a trypsin inhibitor and an anti-inflammatory compound that is made from human urine is a therapeutic option for SJS/TEN. Ulinastatin may provide anti-inflammatory effect by inhibiting TNF-α production, thereby reducing the risk of septic complications and lowering mortality. Until now, the known side effects are nausea, vomiting and allergic to gelatin. Although it has a promising potential, the effectiveness of ulinastatin is still poorly studied. Further research is needed regarding the usage of ulinastatin on patients with SJS/TEN
