الفهرس 
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Abstract
The aim of our study was to determine the association of diabetes mellitus(DM) with prevalence and severity of hepatic encephalopathy(HE)
The study was designed at:
Tropical department of Minia university hospital.
The study included 100 patients HCV related LC with HE they were classified
into 2 groups; first group included 50 patient non- diabetic while second
group included 50 diabetic patients.
Those with the following conditions were excluded from the study:
We excluded patients with Acute liver failure , Heart failure , Renal failure , respiratory failure , History of shunt surgery , transjugular intrahepatic portosystemic shunt , Pregnancy , lactation and Hepatitis- B
Each one of these patients was subjected to:
• Comprehensive History taking.
• Clinical examination.
• Laboratory investigations and abdominal ultrasonography.
• Endoscopy
• Child score determination.
• MELD score
The results of our study showed that:
The most common precipitating factor of hepatic encephalopathy found in our study was repeated vomiting
Increased flapping tremors, LL edema , hepatomegaly in diabetic group than non-diabetic patients.
Anemia and hypo albuminemia were common in diabetic patients but thrombocytopenia was common in non -diabetic patients
The most of diabetic patients presented by high grade of HE (G4) while non- diabetic presented by (G2)
Diabetic patients presented Child C classification
There was positive correlation between HbA1c level and grades of hepatic encephalopathy
The common predictors for HE in our study were flapping tremors , splenomegaly, anemia , esophageal varices and increased HbA1c.