Diabetes (e.g., hyperlipidemia, glycosylation of proteins, etc.),

Diabetes mellitus is a heterogeneous group of disorders characterized by persistent hyperglycemia with disturbance of carbohydrate, lipid and protein metabolism resulting from defects in insulin secretion, insulin action, or both. Diabetes causes about 5% of all deaths globally each year. The chronic hyperglycaemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, liver, nerves, heart, and blood vessels. Fifty percent of people with diabetes die of cardiovascular disease (primarily heart disease and stroke) (1, 2). The characteristic symptoms are excessive urine production, polyuria, excessive thirst and increased fluid intake, Polydipsia (3). The two most common forms of diabetes are type 1 diabetes (T1DM, previously known as insulin-dependent diabetes or IDDM) and type 2 diabetes (T2DM, previously known as non-insulin-dependent diabetes or NIDDM) (4). Type 1diabetes is characterized by autoimmune destruction of pancreatic ?-cells, resulting in a failure to produce sufficient amount of insulin (5). Type 2 diabetes is caused by impaired ?-cells function and capacity to secret enough insulin, coupled to a decline in target tissue sensitivity to insulin (insulin resistance) (6). All forms of diabetes have very serious effects on health. In addition to the consequences of abnormal metabolism of glucose (e.g., hyperlipidemia, glycosylation of proteins, etc.), there are a number of long-term complications associated with the disease. These include cardiovascular, peripheral vascular, hepatocellular injury, ocular, neurologic and renal abnormalities, which are responsible for morbidity, disability and premature death in young adults. Globally, type 2 diabetes is one of the most common, noncommunicable diseases affecting the health of a significant number of the population throughout the world and is increasing at an alarming rate. During the past decades, underweight, malnutrition, and infectious disease as a major health problems threatening the developing world (7). Consequently, diabetes is rapidly rising as global health care problem that threaten to reach endemic level by 2030 The number of people with diabetes (mainly type 2 diabetes) worldwide is projected to increase approximately double between 2000 and 2030 from 171 million to 366 million (8). This increase will be the most visible in developing countries, where the number of people with diabetes is expected to increase from 84 million to 228 million (9).
In Africa, the prevalence of DM is increasing and the magnitude of the disease is progressing .In sub-Saharan Africa, over 12 million people are expected to have diabetes, and 330,000 of these people will die from diabetes related complications. In Ethiopia, according to WHO estimation, the number of diabetics cases in the year 2000 was 800,000 and this number is expected to increase to 1.8 million by the year 2030 (10). The liver plays a key role in the regulation of carbohydrate metabolism, as it uses glucose as a fuel, it has the capability to store glucose as glycogen via glycogenesis and also synthesize glucose from non-carbohydrate precursor through Gluconeogenesis. This type of role makes the liver more susceptible to diseases in subjects having metabolic disorder, especially for diabetes (11). Elevated serum enzymes activity of the aminotransferases; aspartate aminotransferase (AST) and alanine aminotransferase (ALT) is the most frequently measured indicator of liver disease and occurs in diabetics more frequently than in the healthy population (12). In Ethiopia diabetes is recognized as one of the major non communicable disease, but the exact prevalence, progress, and associated complication are not well documented and updated regularly. Therefore, this research paper is aimed to evaluate liver function test enzymes such as ALT, AST and GGT among North West Ethiopian patient with type 2 diabetes as compared with non-diabetic control groups.

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