The effect of diabetes mellitus and its treatment on the lithogenesity of bile in man.

Bile lipid and bile acid compositions of twenty-five diabetic patients (eight males and seventeen females) were compared with those of twenty normal subjects and twelve non-diabetic patients with cholesterol gallstone. Diabetic patients were grouped into the untreated, insulin-treated and untreated patients with gallstone. The results are as follows. The average molar percentage of cholesterol and incidence of lithogenic bile were higher in all the groups of diabetic patients as well as nondiabetic cholesterol gallstone patients than in normal subjects. However, the incidence of lithogenic bile was distinctly higher in diabetic patients treated with insulin and patients with gallstone as compared with untreated patients. The average molar percentage of phospholipids was significantly higher in diabetic patients untreated and treated with insulin than normal controls but was almost normal in diabetic patients with gallstone and non-diabetic cholesterol gallstone patients. Diabetic patients treated with insulin and those with gallstone tended to have a low molar percentage of chenodeoxycholic acid, which was significant in non-diabetic gallstone patients. These results may indicate that the diabetic patients who fall into gallstone have the bile lipid and bile acid compositions that differ from those of diabetic patients without gallstone and that the insulin administration deteriorates lithogenesity of bile in diabetic patients. 22