Management of Diabetes Mellitus in Patients with Chronic Liver Diseases

Abstract

Diabetes mellitus (DM) is a common chronic disease affecting humans globally. During the last few years, the incidence of diabetes has increased and has received more attention. In addition to growing DM populations, DM complications are involving injuries to more organs, such as the heart and cerebral vessel damage. DM complications can reduce quality of life and shorten life spans and eventually also impede social and economic development. Therefore, effective measures to curb the occurrence and development of diabetes assist in improving patients’ quality of life, delay the progression of DM in the population, and ease a social burden. The liver is regarded as an important link in the management and control of DM, including the alleviation of glucose metabolism and lipid metabolism and others via glucose storage and endogenous glucose generation from glycogen stored in the liver. Liver cirrhosis is a very common chronic disease, which often lowers the quality of life and decreases life expectancy. According to a growing body of research, diabetes shows a close correlation with hepatitis, liver cirrhosis, and liver cancer. Moreover, coexistence of liver complications would accelerate the deterioration of patients with diabetes. Liver cirrhosis and diabetes influence each other. Thus, in addition to pharmacological treatments and lifestyle interventions, effective control of cirrhosis might assist in a better management of diabetes. When it comes to different etiologies of liver cirrhosis, different therapeutic methods, such as antiviral treatment, may be more effective. Effective control of cirrhosis might be a strategy for better management of diabetes.

The Burden of Diabetes-Related Preventable Hospitalization: 11-Year Trend and Associated Factors in a Region of Southern Italy

“…Microvascular diabetes complications were associated with both renal disease and peripheral vascular diseases. This relation can explain the significant association of renal disease and amputations, as also known in the recent literature [26,27].…”

Protective role of melatonin against adipose-hepatic metabolic comorbidities in experimentally induced obese rat model

“…These observations are consistent with earlier studies, including a recent study from our laboratory animals which demonstrates that metabolic related syndrome such as obesity causes inflammation in the metabolic tissues, particularly the adipose and hepatic tissues [ 47 , 48 ] and these are well documented pathological features of non-alcoholic fatty liver disease [ 47 , 49 ]. This therefore suggests obesity as a predictor of fatty liver disease, which may become one of the common reasons for liver transplantations by 2030 especially in developed countries [ 49 , 50 ]. Other studies have also reported that obestatin could be protective against oxidative stress and inflammation [ 51 , 52 ].…”

“…It is an anorexigenic hormone that suppresses appetite and gastrointestinal motility and modulates growth hormone and lipid metabolism [ 23 , 24 ]. However, previous studies have reported that obestatin acts as antagonist to the actions of ghrelin on appetite, food intake, gastric emptying and the secretion of growth hormone [ 25 , 26 ]. Zhao et al ., also reported that obestatin is reduced in obese humans [ 27 ].…”

Stationäre Patienten mit der Nebendiagnose Diabetes mellitus: klinische Relevanz

“…Sie sind mit dem Diabetes ätiopathogenetisch und therapeutisch verknüpft. Dazu gehören vordergründig die traditionellen mikro- (Retinopathie, Nephropathie, Neuropathie) und makrovaskulären (koronare Herzerkrankung, periphere arterielle Verschlusskrankheit, Schlaganfall) Diabetesfolgekrankheiten [ 11 , 61 ], aber auch andere ( nichttraditionelle ) ätiopathogenetisch assoziierte Komorbiditäten wie die nichtalkoholische Fettlebererkrankung (NAFLD) mit ihren Komplikationen bis hin zum hepatozellulären Karzinom (HCC: [ 85 , 89 ]), die akute und chronische Pankreatitis [ 18 , 57 , 90 ], das duktale Adenokarzinom des Pankreas [ 12 ] und weitere Krebserkrankungen mit metabolischen Verknüpfungen zum Diabetes [ 69 , 75 ]. Die Erkenntnisse zum (bidirektionalen) Zusammenhang dieser konkordanten Komorbiditäten mit dem Diabetes und den sich daraus ergebenden diagnostisch-therapeutischen Konsequenzen sind teilweise relativ neu und noch nicht flächendeckend von Ärzten aller Fachrichtungen realisiert.…”