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. 2024 Jun 21;21(2):383-391.
doi: 10.5114/aoms/189834. eCollection 2025.

From cirrhosis to hepatogenous diabetes: risk factors and glycemic management

Jing Zhang  1 , Huipeng Zhang  1 , Yunqing Zeng  1 , Yixuan Guo  1 , Tao Zhou  2   3 , Changhong Liu  4 , Rui Ji  1 , Yanjing Gao  1
Affiliations

From cirrhosis to hepatogenous diabetes: risk factors and glycemic management

Jing Zhang et al. Arch Med Sci. .

Abstract

Introduction: Our study analyzed the risk factors associated with hepatogenous diabetes (HD) and compared glycemic control under various treatment modalities.

Material and methods: The multicenter study included 327 patients with HD, while 329 non-diabetic liver cirrhosis (LC) patients were selected as the control group for examining HD risk factors. Three groups of HD patients with HbA1c were distinguished based on their glucose-lowering treatment regimen to compare glycemic control.

Results: The results indicated that longer disease duration of cirrhosis (OR = 1.111, 95% CI: 1.072-1.152, p < 0.001), vertical transmission of hepatitis B (OR = 2.254, 95% CI: 1.239-4.103, p = 0.008), a high Child-Pugh grade (OR = 1.566, 95% CI: 1.202-2.041, p = 0.001) and higher blood triglyceride levels (OR = 2.695, 95% CI: 2.054-3.537, p < 0.001) were independent risk factors for HD. A history of endoscopic treatment (OR = 0.615, 95% CI: 0.407-0.928, p = 0.021) was a protective factor for HD. Insulin or insulin in combination with oral hypoglycemic agents is more effective compared to oral medication alone (p1 < 0.05, p2 < 0.05).

Conclusions: The risk factors for HD include prolonged duration of LC, vertical transmission of hepatitis B, higher Child-Pugh grade, and elevated blood triglyceride levels. A history of endoscopic treatment was found to be a protective factor. Glycemic management was substantially enhanced among patients who received insulin therapy, either alone or combined with oral hypoglycemic drugs, as opposed to those who depended solely on oral hypoglycemic agents.

Keywords: diabetes mellitus; hepatogenous diabetes; insulin resistance; liver cirrhosis; type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Forest plot of multivariate logistic regression analysis of hepatogenous diabetes
Figure 2
Figure 2
Glycemic control in patients with different glucose-lowering treatment prescription patterns. ns: no statistical significance. *P < 0.05. Among the 47 patients in the oral drug therapy group (group 1), 16 (34.0%) exhibited good glycemic control (HbA1c ≤ 7%), while 31 (66.0%) demonstrated poor glycemic control (HbA1c > 7%). In the insulin injection therapy group (group 2), 28 patients (60.9%) exhibited good glycemic control, while 18 (39.1%) patients demonstrated poor glycemic control. In the combined insulin and oral medication group (group 3), 14 (66.7%) patients exhibited good glycemic control, while 7 (33.3%) patients demonstrated poor glycemic control
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