Challenges in diagnosing and monitoring diabetes in patients with chronic liver diseases.

Autor: Silva TE; Division of Gastroenterology, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, Trindade Florianópolis, SC, 88040-970, Brazil. Electronic address: telma.silva@ufsc.br., Ronsoni MF; Division of Endocrinology, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, Trindade, Florianópolis, SC, 88040-970, Brazil., Schiavon LL; Division of Gastroenterology, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, Trindade Florianópolis, SC, 88040-970, Brazil.
Jazyk: angličtina
Zdroj: Diabetes & metabolic syndrome [Diabetes Metab Syndr] 2018 May; Vol. 12 (3), pp. 431-440. Date of Electronic Publication: 2017 Dec 20.
DOI: 10.1016/j.dsx.2017.12.013
Abstrakt: The prevalence and mortality of diabetes mellitus and liver disease have risen in recent years. The liver plays an important role in glucose homeostasis, and various chronic liver diseases have a negative effect on glucose metabolism with the consequent emergence of diabetes. Some aspects related to chronic liver disease can affect diagnostic tools and the monitoring of diabetes and other glucose metabolism disorders, and clinicians must be aware of these limitations in their daily practice. In cirrhotic patients, fasting glucose may be normal in up until 23% of diabetes cases, and glycated hemoglobin provides falsely low results, especially in advanced cirrhosis. Similarly, the performance of alternative glucose monitoring tests, such as fructosamine, glycated albumin and 1,5-anhydroglucitol, also appears to be suboptimal in chronic liver disease. This review will examine the association between changes in glucose metabolism and various liver diseases as well as the particularities associated with the diagnosis and monitoring of diabetes in liver disease patients. Alternatives to routinely recommended tests will be discussed.
(Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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