title: Hepatogenous diabetes: Is it time to separate it from type 2 diabetes?
abstract: By definition, hepatogenous diabetes is directly caused by loss of liver function, implying that it develops after cirrhosis onset. Therefore, it should be distinguished from type 2 diabetes developing before cirrhosis onset, in which specific causes of liver disease play a major role, in addition to traditional risk factors. Currently, although hepatogenous diabetes shows distinct pathophysiological and clinical features, it is not considered as an autonomous entity. Recent evidence suggests that the failing liver exerts an independent "toxic" effect on pancreatic islets resulting in β-cell dysfunction. Moreover, patients with hepatogenous diabetes usually present with normal fasting glucose and haemoglobin A1clevels and abnormal response to an oral glucose tolerance test, which is therefore required for diagnosis. This article discusses the need to separate hepatogenous diabetes from type 2 diabetes occurring in subjects with chronic liver disease and to identify individuals suffering from this condition for prognostic and therapeutic purposes.
authors.affiliation: Diabetes Service, Endocrinology and Metabolic Diseases Unit, IRCCS "Cà Granda-Ospedale Maggiore Policlinico" Foundation, University of Milan, Milan, Italy.|Department of Medical Sciences, University of Milan, Milan, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Orsi
authors.affiliation: Diabetes Service, Endocrinology and Metabolic Diseases Unit, IRCCS "Cà Granda-Ospedale Maggiore Policlinico" Foundation, University of Milan, Milan, Italy.|Department of Medical Sciences, University of Milan, Milan, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Grancini
authors.affiliation: Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy.|Diabetes Unit, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Menini
authors.affiliation: Division of Gastroenterology and Hepatology, A.M. and A. Migliavacca Center for Liver Disease, IRCCS "Cà Granda-Ospedale Maggiore Policlinico" Foundation, University of Milan, Milan, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Aghemo
authors.affiliation: Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy.|Diabetes Unit, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pugliese
mesh_terms: D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D003937:Diagnosis, Differential; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008107:Liver Diseases / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D016031:Liver Transplantation; D011237:Predictive Value of Tests; D015995:Prevalence
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
keywords: cirrhosis; hepatogenous diabetes; insulin resistance; orthotopic liver transplant; β-cell dysfunction