Chung W, Promrat K, Wands J. Clinical implications, diagnosis, and management of diabetes in patients with chronic liver diseases. World J Hepatol 2020; 12(9): 533-557 [PMID: 33033564 DOI: 10.4254/wjh.v12.i9.533]
Corresponding Author of This Article
Waihong Chung, MD, PhD, Doctor, Research Fellow, Division of Gastroenterology, Department of Medicine, Rhode Island Hospital, 245 Chapman Street, Suite 300, Providence, RI 02905, United States. waihongchung@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
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/
World J Hepatol. Sep 27, 2020; 12(9): 533-557 Published online Sep 27, 2020. doi: 10.4254/wjh.v12.i9.533
Clinical implications, diagnosis, and management of diabetes in patients with chronic liver diseases
Waihong Chung, Kittichai Promrat, Jack Wands
Waihong Chung, Division of Gastroenterology, Department of Medicine, Rhode Island Hospital, Providence, RI 02905, United States
Kittichai Promrat, Division of Gastroenterology and Hepatology, Providence VA Medical Center, Providence, RI 02908, United States
Jack Wands, Liver Research Center, The Warren Alpert Medical School of Brown University, Providence, RI 02903, United States
Author contributions: Chung W conducted the literature review and wrote the manuscript; Promrat K reviewed and revised the manuscript; Wands J reviewed the manuscript and supervised the project; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Waihong Chung, MD, PhD, Doctor, Research Fellow, Division of Gastroenterology, Department of Medicine, Rhode Island Hospital, 245 Chapman Street, Suite 300, Providence, RI 02905, United States. waihongchung@gmail.com
Received: July 8, 2020 Peer-review started: July 8, 2020 First decision: July 30, 2020 Revised: August 3, 2020 Accepted: August 15, 2020 Article in press: August 15, 2020 Published online: September 27, 2020 Processing time: 75 Days and 13.4 Hours
Core Tip
Core Tip: Diabetes is an independent risk factor for the development and progression of chronic liver disease (CLD) of various etiologies. Concurrent diabetes and CLD predict worse clinical outcomes, including hepatic decompensation, hepatocellular carcinoma (HCC), and complications following liver transplantation. Traditional glycemic markers, including fasting glucose, oral glucose tolerance test, and hemoglobin A1c, are not accurate in patients with severe CLD. Metformin and α-glucosidase inhibitors are associated with significant benefits beyond glycemic control, including reductions in HCC risk and incidence of hepatic encephalopathy. Glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors may exert a hepatic protective effect irrespective of the degree of glycemic control.
