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From cirrhosis to hepatogenous diabetes: risk factors and glycemic management

Jing Zhang1, Huipeng Zhang1, Yunqing Zeng1

  • 1Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.

Archives of Medical Science : AMS
|May 21, 2025
PubMed

Insights

Hepatogenous diabetes (HD) is linked to prolonged liver cirrhosis, hepatitis B transmission, high Child-Pugh grade, and high triglycerides. Insulin therapy significantly improves glycemic control in HD patients compared to oral medications alone.

Area of Science:

  • Hepatology
  • Endocrinology
  • Gastroenterology

Background:

  • Hepatogenous diabetes (HD) is a complex condition arising secondary to liver disease.
  • Understanding the risk factors and optimal management of HD is crucial for patient outcomes.

Purpose of the Study:

  • To identify independent risk factors for the development of hepatogenous diabetes.
  • To compare the effectiveness of different glucose-lowering treatment modalities in HD patients.

Main Methods:

  • A multicenter study involving 327 HD patients and 329 non-diabetic liver cirrhosis (LC) controls.
  • Analysis of risk factors for HD using logistic regression.
  • Comparison of glycemic control (HbA1c) across three treatment groups of HD patients.

Main Results:

  • Prolonged LC duration (OR=1.111), vertical hepatitis B transmission (OR=2.254), high Child-Pugh grade (OR=1.566), and high triglycerides (OR=2.695) were significant risk factors for HD.
  • Endoscopic treatment history showed a protective effect (OR=0.615).
  • Insulin therapy, alone or combined with oral agents, demonstrated superior glycemic control compared to oral agents alone (p<0.05).

Conclusions:

  • Key risk factors for HD include advanced liver disease, viral hepatitis transmission, and metabolic dysregulation.
  • Endoscopic treatment may offer a protective benefit against HD development.
  • Insulin-based regimens are more effective for managing hyperglycemia in hepatogenous diabetes.
Abstract

Keywords:
diabetes mellitushepatogenous diabetesinsulin resistanceliver cirrhosistype 2 diabetes mellitus

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