Management of Diabetes in Liver Cirrhosis.

Kim,  Jin Hwa

doi:2016.17.3.159

J Korean Diabetes > Volume 17(3); 2016 > Article

Focused Issue

The Journal of Korean Diabetes 2016;17(3):159-163.
DOI: https://doi.org/10.4093/jkd.2016.17.3.159 Published online October 13, 2016.

간경화 환자의 혈당관리

김진화

Management of Diabetes in Liver Cirrhosis.

Jin Hwa Kim

Department of Endocrinology and Metabolism, Chosun University Hospital, Gwangju, Korea. endocrine@chosun.ac.kr

Abstract

Diabetes mellitus (DM) is common in patients with liver cirrhosis, indicating a bidirectional relationship between DM and liver cirrhosis. Type 2 DM is a risk factor for development and progression of chronic liver disease including liver cirrhosis, and DM may occur as a complication of liver cirrhosis. Hyperglycemia and hyperinsulinemia have profibrogenic properties on hepatic stellate cells, and contribute to liver damage by promoting inflammation and fibrosis through an increase in mitochodrial oxidative stress mediated by adipokines. The presence of DM in patients with liver cirrhosis is not only related to the poor survival rate but also associated with major complications of cirrhosis. This suggests that optimal management of DM could be beneficial in patients with liver cirrhosis. However, the management of DM in patients with liver cirrhosis is complex because of impaired liver function and of the potential hepatotoxicity of oral hypoglycemic agents. We review the clinical implications and the therapeutic management of DM in patients with liver cirrhosis.

Key Words: Diabetes mellitus, Glucose control, Liver cirrhosis