Brief Answer:
probably not but needs investigation

Detailed Answer:
Hello,

this is definitely abnormal and requires investigation. I don't know the normal range for this particular lab so please inform me about it or just upload the report. The full report would be helpful to let me know what tests you've done so far and the corresponding results. Mild to moderate elevations of transaminases in patients with diabetes are usually attributed to either fatty liver or drug side effects (statins mostly). I can't suggest any treatment before making a diagnosis.

In patients like you I usually ask for further tests but I still don't know what tests you've done! The tests I'd like to see are alkaline phosphatase, gamma-GT, INR, albumin, gamma-globulins, serum protein electrophoresis, ultrasound scan of the upper abdomen and hepatitis tests: hepatitis B surface antigen and antibody, anti-core antibody IgG and IgM, hepatitis C antibody, hepatitis A antibodies IgG/IgM and antinuclear antibodies, anti-smooth muscle cell and soluble liver antigen. The aforementioned tests would be useful to investigate the cause of this condition and to exclude some serious causes like autoimmune or infectious hepatitis and tumors.

A careful review of your medications is absolutely necessary to see if any of them is or may be involved.

I hope you find my comments helpful!
I'll be glad to continue this discussion when you provide more details or if you'd like to ask for more details or clarifications.

Kind Regards!

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Brief Answer:
ultrasound scan

Detailed Answer:
Thanks for the additional info!

It seems that your blood sugar is under good control although using lantus and novomix is a little strange as a combination because lantus is a basal insulin and novomix has a basal and a bolus component. There is need to do two basal insulins but since it works that's fine!

You've got a low vitamin D and need supplementation. You can try daily vitamin D3 (about 2000 units should suffice) and check the levels of 25(OH) vitamin D3 again after a couple of months. This is not the cause of your liver problems though.

Your LDL cholesterol is above the target levels for patients with diabetes (100mg/dL), so statin treatment is recommended. Keep in mind that statin (particularly in high doses) may also affect the liver but low doses are rarely implicated in serious liver complications.

The rest of your tests are OK besides the liver function tests. They're are too high though. The highest value is about 2.5 times the upper normal limit which is considered to be a mild elevation only. In such cases checking the liver anatomy is required as a first step. The easiest way to do that is with a liver ultrasound scan of the upper abdomen. The tests for autoimmunity I've suggested may follow (antinuclear, anti-smooth muscle cell, soluble liver antigen) and the same applies for the infectious hepatitis markers.

If you've done these tests recently please upload the reports. Otherwise I suggest you talk about them with your doctor. Obviously I can't suggest any drug at this point besides a statin and vitamin D3. Remember to talk with your doctor about any change in your regimen because it's your doctor who knows the full details of your medical history.

Kind Regards!

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Brief Answer:
please read carefully

Detailed Answer:
Hello again,

this service is not supposed to replace your doctor. It's supposed to help you understand your medical situation and help you take the right decisions. I've already suggested a route of investigation which is required to get to the diagnosis. The reports you've provided are not diagnostic. They are just test reports. I've suggested some extra testing which you haven't done or informed me about it.

Regarding treatment I've already explained to you that the diagnosis comes first. Doctors don't give prescriptions based on a test report. We need a diagnosis but don't have it yet. Perhaps if you'd done the tests I've mentioned, the diagnosis would have been easier to find.

I suggested a statin for your unfavorable lipid profile and vitamin D3 to treat your vitamin deficiency. But none of the above address your liver issues. The liver issue requires more testing.

I hope it's clear enough now. Please do not hesitate to contact me if you need more clarifications.

Kind Regards!

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