Hepatogenous diabetes. Current views of an ancient problem
Diabetes developed as a complication of cirrhosis is known as «hepatogenous diabetes» (HD). Around 30% to 60% of cirrhotic patients suffer from this metabolic disorder. Insulin resistance in muscular, hepatic and adipose tissues as well as hyperinsulinemia, seem to be pathophysiologic bases for HD....
| Autores principales: | , , |
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| Formato: | Artículo |
| Lenguaje: | inglés |
| Publicado: |
Elsevier España
2009
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| Materias: | |
| Acceso en línea: | http://eprints.uanl.mx/29960/7/29960.pdf |
| _version_ | 1836640496849518592 |
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| author | García Compeán, Diego Jáquez Quintana, Joel Omar Maldonado Garza, Héctor Jesús |
| author_facet | García Compeán, Diego Jáquez Quintana, Joel Omar Maldonado Garza, Héctor Jesús |
| author_sort | García Compeán, Diego |
| collection | Repositorio Institucional |
| description | Diabetes developed as a complication of cirrhosis is known as «hepatogenous diabetes» (HD). Around 30% to 60% of cirrhotic patients suffer from this metabolic disorder. Insulin resistance in muscular, hepatic and adipose tissues as well as hyperinsulinemia, seem to be pathophysiologic bases for HD. An impaired response of the islet E-cells of the pancreas and the hepatic insulin resistance are also contributing factors. Diabetes develops when defective oxidative and nonoxidative muscle glucose metabolism develops. Non-alcoholic fatty liver disease (NAFLD), alcoholic cirrhosis, chronic hepatitis C (CHC), and hemochromatosis are more frequently associated with HD. HD in early cirrhosis stages may be subclinical. Only insulin resistance and glucose intolerance may be observed. As liver disease advances, diabetes becomes clinically manifest, therefore HD may be considered as a marker for liver function deterioration. HD is clinically different from that
of type 2 DM since it is less frequently associated with microangiopathy and patients suffer complications of cirrhosis more frequently as well as increased mortality. Insulin resistance and HD associate to a decrease in the sustained response to antiviral therapy and an increased progression of fibrosis in patients with CHC. Diabetes treatment is complex due to liver damage and hepatotoxicity of oral hypoglycemic drugs that are frequently prescribed to these patients. This paper will review current concepts in relation to the pathophysiology, the impact on the clinical outcome of cirrhosis, and the therapy of HD. Finally, the role of HD as a risk factor for the occurrence and exacerbation of hepatocellular carcinoma (HCC) will also be reviewed. |
| format | Article |
| id | eprints-29960 |
| institution | UANL |
| language | English |
| publishDate | 2009 |
| publisher | Elsevier España |
| record_format | eprints |
| spelling | eprints-299602025-07-02T16:50:20Z http://eprints.uanl.mx/29960/ Hepatogenous diabetes. Current views of an ancient problem García Compeán, Diego Jáquez Quintana, Joel Omar Maldonado Garza, Héctor Jesús RC Medicina Interna, Psiquiatría, Neurología Diabetes developed as a complication of cirrhosis is known as «hepatogenous diabetes» (HD). Around 30% to 60% of cirrhotic patients suffer from this metabolic disorder. Insulin resistance in muscular, hepatic and adipose tissues as well as hyperinsulinemia, seem to be pathophysiologic bases for HD. An impaired response of the islet E-cells of the pancreas and the hepatic insulin resistance are also contributing factors. Diabetes develops when defective oxidative and nonoxidative muscle glucose metabolism develops. Non-alcoholic fatty liver disease (NAFLD), alcoholic cirrhosis, chronic hepatitis C (CHC), and hemochromatosis are more frequently associated with HD. HD in early cirrhosis stages may be subclinical. Only insulin resistance and glucose intolerance may be observed. As liver disease advances, diabetes becomes clinically manifest, therefore HD may be considered as a marker for liver function deterioration. HD is clinically different from that of type 2 DM since it is less frequently associated with microangiopathy and patients suffer complications of cirrhosis more frequently as well as increased mortality. Insulin resistance and HD associate to a decrease in the sustained response to antiviral therapy and an increased progression of fibrosis in patients with CHC. Diabetes treatment is complex due to liver damage and hepatotoxicity of oral hypoglycemic drugs that are frequently prescribed to these patients. This paper will review current concepts in relation to the pathophysiology, the impact on the clinical outcome of cirrhosis, and the therapy of HD. Finally, the role of HD as a risk factor for the occurrence and exacerbation of hepatocellular carcinoma (HCC) will also be reviewed. Elsevier España 2009 Article PeerReviewed text en cc_by_nc_nd http://eprints.uanl.mx/29960/7/29960.pdf http://eprints.uanl.mx/29960/7.haspreviewThumbnailVersion/29960.pdf García Compeán, Diego y Jáquez Quintana, Joel Omar y Maldonado Garza, Héctor Jesús (2009) Hepatogenous diabetes. Current views of an ancient problem. Annals of Hepatology, 8 (1). pp. 13-20. ISSN 16652681 doi:10.1016/S1665-2681(19)31805-8 |
| spellingShingle | RC Medicina Interna, Psiquiatría, Neurología García Compeán, Diego Jáquez Quintana, Joel Omar Maldonado Garza, Héctor Jesús Hepatogenous diabetes. Current views of an ancient problem |
| thumbnail | https://rediab.uanl.mx/themes/sandal5/images/online.png |
| title | Hepatogenous diabetes. Current views of an ancient problem |
| title_full | Hepatogenous diabetes. Current views of an ancient problem |
| title_fullStr | Hepatogenous diabetes. Current views of an ancient problem |
| title_full_unstemmed | Hepatogenous diabetes. Current views of an ancient problem |
| title_short | Hepatogenous diabetes. Current views of an ancient problem |
| title_sort | hepatogenous diabetes current views of an ancient problem |
| topic | RC Medicina Interna, Psiquiatría, Neurología |
| url | http://eprints.uanl.mx/29960/7/29960.pdf |
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