Liver transplantation improves cirrhosis-associated impaired oral glucose tolerance.
BACKGROUND
Thirty-five percent to 80% of cirrhotic patients have impaired glucose tolerance (IGT) or diabetes mellitus (DM). Diabetic cirrhotics have higher morbidity and mortality than nondiabetics. Therefore, it would be worthwhile to determine whether liver transplantation improves glucose homeostasis in these patients.


METHODS
A total of 26 patients awaiting liver transplantation were evaluated for impaired glucose homeostasis by fasting blood glucose and/or oral glucose tolerance tests (OGTT). Five patients underwent transplant surgery within 1 year of OGTT and had a repeat OGTT 3-6 months after transplantation.


RESULTS
Sixty-five percent (17/26) of the patients had abnormal glucose homeostasis. Twenty-three percent (6/26) met American Diabetes Association criteria for DM, and another 42.3% (11/26) had IGT. All patients had normal HbA1C levels. After transplantation, the 2-hr blood glucose improved in four patients and the mean 2-hr glucose level was reduced (204 +/- 94 vs. 132 +/- 53 mg/dl [mean +/- SD, P=0.051]).


CONCLUSIONS
Liver transplantation can reverse cirrhosis-associated impaired glucose tolerance.
Shetty
A
A
Department of Medicine, University of Maryland Medical System, Baltimore, USA.
Wilson
S
S
Kuo
P
P
Laurin
J L
JL
Howell
C D
CD
Johnson
L
L
Allen
E M
EM
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D005947:Glucose / Q000378:metabolism / Q000494:pharmacology*; D005951:Glucose Tolerance Test; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D008103:Liver Cirrhosis / Q000503:physiopathology* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies
D001786:Blood Glucose; D005947:Glucose