J Korean Diabetes.  2016 Sep;17(3):159-163. 10.4093/jkd.2016.17.3.159.

Management of Diabetes in Liver Cirrhosis

• Kim JH

• KMID: 2354279
• DOI: http://doi.org/10.4093/jkd.2016.17.3.159

Abstract

Diabetes mellitus (DM) is common in patients with liver cirrhosis, indicating a bidirectional relationship between DM and liver cirrhosis. Type 2 DM is a risk factor for development and progression of chronic liver disease including liver cirrhosis, and DM may occur as a complication of liver cirrhosis. Hyperglycemia and hyperinsulinemia have profibrogenic properties on hepatic stellate cells, and contribute to liver damage by promoting inflammation and fibrosis through an increase in mitochodrial oxidative stress mediated by adipokines. The presence of DM in patients with liver cirrhosis is not only related to the poor survival rate but also associated with major complications of cirrhosis. This suggests that optimal management of DM could be beneficial in patients with liver cirrhosis. However, the management of DM in patients with liver cirrhosis is complex because of impaired liver function and of the potential hepatotoxicity of oral hypoglycemic agents. We review the clinical implications and the therapeutic management of DM in patients with liver cirrhosis.

Keyword

Diabetes mellitus; Glucose control; Liver cirrhosis

MeSH Terms

Adipokines
Diabetes Mellitus
Fibrosis
Hepatic Stellate Cells
Humans
Hyperglycemia
Hyperinsulinism
Hypoglycemic Agents
Inflammation
Liver Cirrhosis*
Liver Diseases
Liver*
Oxidative Stress
Risk Factors
Survival Rate
Adipokines
Hypoglycemic Agents