A case of a diabetic patient with alcoholic liver cirrhosis in which glucose intolerance has improved markedly after Hassab's operation for portal hypertension

The patient was a 60-year-old Japanese man with chronic alcoholism who presented with lower limb edema, abdominal distension and hyperglycemia(plasma glucose, 501 mg/dl;HbA1c, 9.2 %). A diagnosis of diabetes mellitus with liver cirrhosis was made and insulin therapy (48-64 IU/day) was started in 2010. For half a year the patient was under good diabetic control, however, his condition deteriorated (FPG; 408 mg/dl and HbA1c; 11.5 %). He was admitted with portal hypertension and Hassabs' surgery was performed in 2011. Following surgery, he made a recovery from portal hypertension and an improvement was observed in his diabetic-control. His glucose intolerance improved and insulin therapy was discontinued. He was discharged under good diabetic control (HbA1c; 5.5 %) with glimepiride treatment (0.5 mg/day). The glimepiride treatment was eventually ceased. We hope this case report will help some readers treat patients with portal hypertension and insulin-resistant diabetes mellitus more effectively.