Abstract
Hepatic enlargement is not a common complication of diabetes mellitus. Its incidence is much higher during the first 2 decades of life than later. 1 Excluding cirrhosis of the liver, the most frequent pathological finding in cases of this type is a fatty infiltration and degeneration of the liver.
As a rule the condition occurs in severe and uncontrolled diabetics. 1 , 2 In most cases, adequate management of the diabetes with diet and insulin, and more recently with protamine-zinc-insulin 1 , 2 results in hepatic recession. However, there are instances where careful dietary management coupled with adequate insulin therapy fails to accomplish a return of the liver to its normal size. We have in our own clinic 4 patients whose livers have enlarged progressively in spite of such treatment.
In animal experimentation, similar experiences have been encountered. It has been observed that completely depancreatized dogs, even though they were treated with insulin, showed extensive fatty infiltration and degeneration of the liver. The changes did not occur, however, if the dietetic and insulin therapy were supplemented by the feeding of raw whole pancreas. 3 , 4
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