Editorial
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2016; 22(10): 2869-2874
Published online Mar 14, 2016. doi: 10.3748/wjg.v22.i10.2869
Hepatogenous diabetes: Is it a neglected condition in chronic liver disease?
Diego García-Compeán, José Alberto González-González, Fernando Javier Lavalle-González, Emmanuel Irineo González-Moreno, Jesús Zacarías Villarreal-Pérez, Héctor Jesús Maldonado-Garza
Diego García-Compeán, José Alberto González-González, Emmanuel Irineo González-Moreno, Héctor Jesús Maldonado-Garza, Gastroenterology Service and Department of Internal Medicine, University Hospital “Dr. José E. González” and Medical School, Universidad Autónoma de Nuevo León, Monterrey 64320, México
Fernando Javier Lavalle-González, Jesús Zacarías Villarreal-Pérez, Endocrinology Service and Department of Internal Medicine, University Hospital “Dr. José E. González” and Medical School, Universidad Autónoma de Nuevo León, Monterrey 64320, México
Author contributions: All the authors contributed equally to the revision of the content of this manuscript; and García-Compeán D conceived and wrote the editorial.
Supported by the Department of Endocrinology and Service of Gastroenterology of the Faculty of Medicine, Autonomous University of Nuevo Leon.
Conflict-of-interest statement: All authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Diego García-Compeán, MD, MMSc, Gastroenterology Service and Department of Internal Medicine, University Hospital “Dr. José E. González” and Medical School, Universidad Autónoma de Nuevo León, Madero y Gonzalitos S/N, Monterrey 64320, México. digarciacompean@prodigy.net.mx
Telephone: +52-81-83487315 Fax: +52-81-89891381
Received: December 23, 2015
Peer-review started: December 24, 2015
First decision: January 13, 2016
Revised: January 20, 2016
Accepted: February 20, 2016
Article in press: February 22, 2016
Published online: March 14, 2016
Processing time: 72 Days and 10.4 Hours
Abstract

Diabetes mellitus (DM) that occurs because of chronic liver disease (CLD) is known as hepatogenous diabetes (HD). Although the association of diabetes and liver cirrhosis was described forty years ago, it was scarcely studied for long time. Patients suffering from this condition have low frequency of risk factors of type 2 DM. Its incidence is higher in CLD of viral, alcoholic and cryptogenic etiology. Its pathophysiology relates to liver damage, pancreatic dysfunction, interactions between hepatitis C virus (HCV) and glucose metabolism mechanisms and genetic susceptibility. It associates with increased rate of liver complications and hepatocellular carcinoma, and decreased 5-year survival rate. It reduces sustained virological response in HCV infected patients. In spite of these evidences, the American Diabetes Association does not recognize HD. In addition, the impact of glucose control on clinical outcomes of patients has not been evaluated. Treatment of diabetes may be difficult due to liver insufficiency and hepatotoxicity of antidiabetic drugs. Notwithstanding, no therapeutic guidelines have been implemented up to date. In this editorial, authors discuss the reasons why they think that HD may be a neglected pathological condition and call attention to the necessity for more clinical research on different fields of this disease.

Keywords: Hepatogenous diabetes; Diabetes mellitus; Outcomes; Therapy; Hepatitis C virus; Chronic liver disease

Core tip: The authors expose arguments, which indicate that hepatogenous diabetes has not received enough attention for many years. They provide published evidences that make them to propose that this entity should be considered as a complication of chronic liver disease, and that an oral glucose tolerance test must be done to patients without previous diabetes mellitus showing normal fasting plasma glucose levels. They also propose that an adequate treatment of hyperglycemia with liver friendly-drugs must be undertaken for reducing complications and mortality. They also highlight the lack of research on long-term treatment of diabetes and the lack of treatment recommendations for these vulnerable patients.