| Summary: | Diabetes mellitus (DM) that occurs because of chronic
liver disease (CLD) is known as hepatogenous diabetes
(HD). Although the association of diabetes and liver
cirrhosis was described forty years ago, it was scarcely
studied for long time. Patients suffering from this
condition have low frequency of risk factors of type
2 DM. Its incidence is higher in CLD of viral, alcoholic
and cryptogenic etiology. Its pathophysiology relates
to liver damage, pancreatic dysfunction, interactions
between hepatitis C virus (HCV) and glucose metabolism
mechanisms and genetic susceptibility. It
associates with increased rate of liver complications
and hepatocellular carcinoma, and decreased 5-year
survival rate. It reduces sustained virological response
in HCV infected patients. In spite of these evidences,
the American Diabetes Association does not recognize
HD. In addition, the impact of glucose control on
clinical outcomes of patients has not been evaluated.
Treatment of diabetes may be difficult due to liver
insufficiency and hepatotoxicity of antidiabetic drugs.
Notwithstanding, no therapeutic guidelines have been
implemented up to date. In this editorial, authors
discuss the reasons why they think that HD may be a
neglected pathological condition and call attention to
the necessity for more clinical research on different
fields of this disease.
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