Objective: This study aims to determine whether ultrasound elastography (fibroscan) is more sensitive and specific in detecting fatty liver and fibrosis as compared to ultrasound and elevated serum aminotransferase levels in patients with type 2 diabetes mellitus and metabolic syndrome. Methodology: All elastography results from January to December, 2013 were reviewed. A total of 102 patients met the inclusion/exclusion criteria. The sensitivity and specificity of elastograph, ultrasound, ALT and AST were computed, with fibrosis score as the surrogate gold standard. Results: Elastography was found to be more sensitive compared to ultrasound for patients with diabetes and metabolic syndrome who have high and moderate probability of fibrosis (100% vs 82.5%, p-value = 0.0036 and 96% vs 76.4%, p-value = 0.0036, respectively). The elastograph is also more specific compared to ultrasound (86.49% vs 32.43%, p-value = 0.0000) for detecting fatty liver and fibrosis. Only elastography was found to be significantly associated with the surrogate gold standard used in this study. Conclusion Elastograph (fibroscan) is more sensitive and specific than ultrasound in detecting fatty liver in the presence of severe and moderate probability for fibrosis. Ultrasound, ALT and AST showed no correlation with fibrosis score.
Non-alcoholic Fatty Liver Disease ; Elasticity Imaging Techniques ; Diabetes Mellitus, Type 2 ; Metabolic Syndrome

INTRODUCTION: Dietary intervention remains an important factor in the management of diabetes mellitus, and many patients have employed herbs and oils to help manage their chronic diseases. Extra virgin olive oil (EVOO) is widely known for its cardio-vascular benefits. However, its effect on the blood glucose of type 2 diabetes mellitus patients has not been extensively studied. In this study, we aimed to determine if the addition of EVOO to meals results in a lower postprandial blood glucose among type 2 diabetes mellitus patients. METHODS: Thirteen patients were included in this randomized controlled cross-over trial. They were randomized to receive a meal with or without EVOO followed by a one week washout period, where they were given the other intervention. The primary outcome is the trans-meal blood glucose, which was calculated as the percent change in two-hour postprandial blood glucose. RESULTS: In group A, there was a noted 88.55% increase in two-hour postprandial blood glucose in taking meals with EVOO, versus 72.11% change in meals without EVOO. The same was observed in Group B, with a 71.08% and 49.22% increase in two-hour postprandial blood glucose in meals with EVOO and without EVOO, respectively. The difference was significant with a p-value of 0.044. Free fatty acids inhibit glucose transport and insulin secretion, this effect may be more predominant in asian type 2 diabetes mellitus patients. CONCLUSION: This study found that adding extra virgin olive oil on top of meals provided no additional benefit in terms of post-prandial glucose excursion.
Diet, Diabetic