Management of diabetes mellitus in patients with cirrhosis: An overview and joint statement

Diabetes Metab. 2021 Sep;47(5):101272. doi: 10.1016/j.diabet.2021.101272. Epub 2021 Aug 4.

Abstract

Type 2 diabetes mellitus (T2DM) is a frequent comorbidity in patients with cirrhosis that is projected to rise in prevalence due to the worldwide burden of obesity, insulin-resistance and non-alcoholic fatty liver disease. The management of T2DM in patients with cirrhosis is complex given the requirement for accurate adaptation according to the level of liver function impairment, with lack of summary of the little evidence available in the literature. Here, we summarise the data available with respect to the epidemiology and the impact of T2DM in patients with cirrhosis, as well as those on the management of T2DM in these patients. We provide guidance for the diagnosis of T2DM and the monitoring of glycaemic control in patients with cirrhosis, and for the management of nutrition and pharmacological treatments in relation to the level of liver dysfunction.

Keywords: Cirrhosis; Diagnosis; Epidemiology; Monitoring; Pharmacological treatment; Type 2 diabetes mellitus.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetes Mellitus, Type 2* / therapy
  • Fibrosis
  • Humans
  • Insulin Resistance
  • Liver Cirrhosis* / complications
  • Liver Cirrhosis* / epidemiology
  • Liver Cirrhosis* / therapy
  • Non-alcoholic Fatty Liver Disease / complications
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Non-alcoholic Fatty Liver Disease / therapy