Clinical manifestations and treatment options in patients with cirrhosis and diabetes mellitus.

Gundling, F; Seidl, H; Strassen, I; Haller, B; Siegmund, T; Umgelter, A; Pehl, C; Schepp, W; Schumm-Draeger, P M

doi:10.1159/000343458

journal article

Document type:: Journal Article
Author(s):: Gundling, F; Seidl, H; Strassen, I; Haller, B; Siegmund, T; Umgelter, A; Pehl, C; Schepp, W; Schumm-Draeger, P M
Title:: Clinical manifestations and treatment options in patients with cirrhosis and diabetes mellitus.
Abstract:: Diabetes is frequently diagnosed in patients with cirrhosis and represents an important risk factor for morbidity and mortality. Pharmacological therapy is limited due to hepatotoxicity and the risk of hypoglycemia. Investigations on medical practice in this patient population, frequency of diabetes-associated complications and the impact of quality of metabolic control are rare.A retrospective analysis was performed to compare the effects of hypoglycemic treatment, the achieved glycemic control under therapy, the prevalence of typical cirrhosis-related or microangiopathic complications, and cardiovascular comorbidities between a group of diabetic patients with cirrhosis (n = 87) and a nondiabetic cirrhotic population (n = 198).The prevalence of diabetes in our cohort was 30.5%. Of all diabetic patients, 39.1% received therapy which might potentially result in serious side effects in patients with end-stage liver disease. The rate of ongoing alcohol abuse (28.7%) and noncompliance under medication (41.4%) was high. Only 28.7% of all diabetic subjects showed satisfactory (as defined by HbA1c <= 6.5%) glycemic control under therapy. Patients achieving satisfactory control experienced a lower rate of certain cirrhosis-related complications such as hepatic encephalopathy (HE) and hepatocellular carcinoma (HCC), arterial hypertension, and hypercholesterolemia. HE was significantly more frequent in diabetic than nondiabetic cirrhotic patients.
Journal title abbreviation:: Digestion
Year:: 2013
Journal volume:: 87
Journal issue:: 2
Pages contribution:: 75-84
Language:: eng
Fulltext / DOI:: doi:10.1159/000343458
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/23306648
Print-ISSN:: 0012-2823
TUM Institution:: II. Medizinische Klinik und Poliklinik (Gastroenterologie); Institut für Medizinische Statistik und Epidemiologie
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