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DEAR EDITOR, We agree with the overall content of the article published by Diego García-Compeàn, et al. in volume 14 of 20151concerning the treatment of diabetes mellitus (DM) in patients with liver cirrhosis (CLD). Therein the authors emphasize the difficulties encountered in clinical practice, including especially the high hypoglycemic risk associated with insulin, and suggest the use of rapid acting analogues and insulin degludec to minimize it. For many years our group has dealt with similar problems and has accrued some experience with insulin utilization in CLD: this further strengthens what is stated in the above-mentioned article. Insulin treatment is frequently required in patients with DM and CLD at doses which, however, may vary significantly. For example, insulin requirement may be decreased in patients with decompensated CLD due to impaired gluconeogenesis and hepatic insulin breakdown. However, there is evidence that the association of CLD with type 2 diabetes (T2DM) is characterized by variable degrees of insulin resistance.

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2016-06-23   |   140 visitas   |   Evalua este artículo 0 valoraciones

Vol. 15 Núm.2. Marzo-Abril 2016 Pags. 287-288 Ann Hepatol 2016; 15(2)