HEPATOMEGALY IN JUVENILE DIABETES MELLITUS TREATED WITH PANCREATIC EXTRACT

Hepatic enlargement is not a common complication of diabetes mellitus. Its incidence is much higher during the first two decades of life than later.¹ Excluding cirrhosis of the liver, the most frequent pathologic change in cases of this type consists of fatty infiltration and degeneration of the liver. The literature on the subject has been meager. White² reported on 7 young diabetic patients in whom extensive fatty infiltration was demonstrated at autopsy. In a two and one-half year period Hanssen¹ found that 12 of 44 diabetic patients under 20 years of age had enlargement of the liver.

As a rule, the condition is associated with severe and uncontrolled diabetic involvement.³ In most cases, adequate management of the diabetes with diet and control and administration of insulin and, more recently, of protamine zinc insulin³ results in hepatic recession. However, there are instances in which careful dietary