García-Compeán Diego, Jáquez-Quintana Joel O, González-González José A, Lavalle-González Fernando J, Villarreal-Pérez Jesús Z, Maldonado-Garza Hector J
Servicio de Gastroenterología y Departamento de Medicina Interna, Hospital Universitario Dr. José E. González, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, México.
Gastroenterol Hepatol. 2013 Aug-Sep;36(7):473-82. doi: 10.1016/j.gastrohep.2013.01.012. Epub 2013 Apr 28.
The prevalence of overt diabetes mellitus (DM) in liver cirrhosis is about 30%. However, DM or impaired glucose tolerance can be observed in 90% after an oral glucose tolerance test in patients with normal fasting plasma glucose. Type 2 DM may produce cirrhosis, whereas DM may be a complication of cirrhosis. The latter is known as «hepatogenous diabetes». Overt and subclinical DM is associated with liver complications and death in cirrhotic patients. Treating diabetes is difficult in cirrhotic patients because of the metabolic impairments due to liver disease and because the most appropriate pharmacologic treatment has not been defined. It is also unknown if glycemic control with hypoglycemic agents has any impact on the course of the liver disease.
肝硬化患者中显性糖尿病（DM）的患病率约为30%。然而，空腹血糖正常的患者在口服葡萄糖耐量试验后，90%可观察到糖尿病或糖耐量受损。2型糖尿病可能导致肝硬化，而糖尿病也可能是肝硬化的并发症。后者被称为“肝源性糖尿病”。显性和亚临床糖尿病与肝硬化患者的肝脏并发症及死亡相关。由于肝脏疾病导致的代谢障碍以及尚未确定最合适的药物治疗方案，肝硬化患者的糖尿病治疗较为困难。使用降糖药物进行血糖控制是否会对肝脏疾病进程产生影响也尚不清楚。
