title: [Diabetes mellitus and cirrhosis of the liver: a prognostically unfavourable combination].
abstract: 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.
authors.affiliation: Catharina Ziekenhuis, afd. Interne Geneeskunde, Eindhoven, the Netherlands. nickwlazlo@gmail.com
authors.forename: Nick
authors.initials: N
authors.lastname: Wlazlo
authors.forename: Hans P
authors.initials: HP
authors.lastname: Sauerwein
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Schoon
authors.forename: C D A Coen
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: Bert
authors.initials: B
authors.lastname: Bravenboer
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000401:mortality; D018450:Disease Progression; D006801:Humans; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000150:complications* / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors