- We conducted a literature search to determine the prognostic effect of diabetes in patients with cirrhosis of the liver. We also searched for evidence on diagnosis and treatment of diabetes in these patients.- Insulin resistance occurs in obese patients with cirrhosis due to non-alcoholic steatohepatitis, but also develops in patients with alcoholic or viral cirrhosis. Eventually, 20-40% of patients with cirrhosis have manifest diabetes mellitus.- Diabetes mellitus may accelerate progression of liver fibrosis to cirrhosis and may lead to higher mortality rates among cirrhosis patients, largely due to infections and liver failure.- Treatment of diabetes in patients with chronic liver disease can theoretically improve survival.- In treating such patients, doctors should take into account the reduced clearance of insulin and oral antidiabetic agents in the liver.
|Journal||Nederlands Tijdschrift voor Geneeskunde|
|Publication status||Published - 1 Jan 2011|