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hepatogenous diabetes:Knowledge,evidence,and skepticism

World Journal of Hepatology 2022年第7期14卷 1291-1306页

作者： Ramesh Kumar Diego García-Compeán Tanmoy Maji Department of Gastroenterology All India Institute of Medical SciencesPatna 801507BiharIndia Department of Gastroenterology University HospitalUniversidad Autónoma de Nuevo LeónMéxicoMonterrey 64700México

The diabetogenic potential of liver cirrhosis(LC)has been known for a long time,and the name"hepatogenous diabetes"(HD)was coined in 1906 to define the *** mellitus(DM)that develops as a consequence of LC is referred to as *** patients with LC,the prevalence rates of HD have been reported to vary from 21%to 57%.The pathophysiological basis of HD seems to involve insulin resistance(IR)and pancreaticβ-cell *** neurohormonal changes,endotoxemia,and chronic inflammation of LC initially create IR;however,the toxic effects eventually lead toβ-cell dysfunction,which marks the transition from impaired glucose tolerance to *** addition,a number of factors,including sarcopenia,sarcopenic obesity,gut dysbiosis,and hyperammonemia,have recently been linked to impaired glucose metabolism in *** is associated with complications and poor outcomes in patients with LC,although the individual impact of each type 2 DM and HD is unknown due to a lack of categorization of diabetes in most published *** fact,there is much skepticism within scientific organizations over the recognition of HD as a separate disease and a consequence of ***,T2DM and HD are being treated in a similar manner although no standardized guidelines are *** different pathophysiological basis of HD may have an impact on treatment *** review article discusses the existence of HD as a distinct entity with high prevalence rates,a strong pathophysiological basis,clinical and therapeutic implications,as well as widespread skepticism and knowledge gaps.

关键词： Cirrhosis diabetes hepatogenous diabetes Glucose intolerance Insulin resistance Metabolism

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Clinical implications of diabetes in chronic liver disease:Diagnosis,outcomes and management,current and future perspectives

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World Journal of Gastroenterology 2022年第8期28卷 775-793页

作者： Diego García-Compeán Emanuela Orsi Ramesh Kumar Felix Gundling Tsutomu Nishida Jesús Zacarías Villarreal-Pérez Ángel N Del Cueto-Aguilera JoséA González-González Giuseppe Pugliese Gastroenterology Service and Department of Internal Medicine Faculty of MedicineUniversity Hospital“Dr.JoséE.González”Universidad Autónoma de Nuevo LeónMonterrey 64700Nuevo LeónMexico diabetes Service Endocrinology and Metabolic Diseases UnitFdn IRCCS Ca GrandaEndocrine UnitPadigl GranelliMilan 20121Italy Department of Gastroenterology All India Institute of Medical SciencesPatna 801507India Department of Gastroenterology Gastrointestinal OncologyHepatologyDiabeticsMetabolism and Infectious DiseasesSozialstiftung BambergBamberg 96049Germany Department of Gastroenterology Toyonaka Municipal HospitalOsaka 560-8565Japan Department of Endocrinology University HospitalAutonomous University of Nuevo LeónMonterrey 64700Mexico Department of Gastroenterology and Internal Medicine Faculty of MedicineUniversity HospitalAutonomous University of Nuevo LeónMonterrey 64700Nuevo LeónMexico Gastroenterology Service and Department of Internal Medicine University Hospital Dr.JoséE González and Medical SchoolMonterrey 64460Nuevo LeónMexico Department of Clinical and Molecular Medicine La Sapienza UniversityRoma 00161Italy

diabetes mellitus(DM)is common in liver cirrhosis(LC).The pathophysiological association is *** is a risk factor of LC and LC is a diabetogenic *** the recent years,research on different aspects of the association DM and LC has been ***,it has been insufficient and still exist many *** aims of this review are:(1)To discuss the latest understandings of the association of DM and LC in order to identify the strategies of early diagnosis;(2)To evaluate the impact of DM on outcomes of LC patients;and(3)To select the most adequate management benefiting the two *** searches were conducted using Pub Med,Ovid and Scopus engines for DM and LC,diagnosis,outcomes and *** authors also provided insight from their own published *** on the published studies,two types of DM associated with LC have emerged:Type 2 DM(T2 DM)and hepatogenous diabetes(HD).High-quality evidences have determined that T2 DM or HD significantly increase complications and death pre and post-liver *** has been poorly studied and has not been recognized as a complication of *** management of DM in LC patients continues to be difficult and should be based on drug pharmacokinetics and the degree of liver *** conclusion,the clinical impact of DM in outcomes of LC patients has been the most studied item *** many gaps still exist particularly in the *** most important gaps were highlighted in order to propose future lines for research.

关键词： diabetes mellitus Liver cirrhosis hepatogenous diabetes Clinical implications Therapy

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A Review on the Role of Low Glycemic Index Foods for Glycemic Control in Chronic Liver Disease

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Food and Nutrition Sciences 2023年第3期14卷 258-276页

作者： Rachana Bhoite Nandan Arun Joshi Varalakshmi Lalithya Pratti Vinita Satyavrat Dr. Reddy’s Laboratories Pvt Ltd. Ameerpet Hyderabad India

Liver is an essential organ that maintains fasting and postprandial blood glucose response via various metabolic pathways. The liver function gradually deteriorates in chronic liver disease (CLD) due to inflammation and destruction of liver parenchyma. The development of glucose intolerance and hepatogenous diabetes (HD) in patients with CLD is an inevitable event. diabetes and CLD can coexist, and function synergistically to cause unfavorable clinical consequences, including poor treatment outcomes and frequent hospitalization. The complications associated with liver disease (malnutrition, hypoglycemia, acute kidney injury, lactic acidosis, etc.) and lack of guidelines limit pharmacological management of HD. Dietary recommendations by The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines (2019), suggested weight reducing hypocaloric diet along with adequate branched-chain amino acid (BCAA) and micronutrient consumption to improve steatosis and insulin sensitivity in patients with CLD. Dietary glycemic index controls prognosis of obesity, non-alcoholic fatty liver disease (NAFLD) and diabetes. The importance of low GI diet in reducing fasting blood glucose, hepatic glucose influx and fat accumulation, thereby improving weight loss and NAFLD score, is being published in patients with diabetes or liver disease. Several countries have already incorporated GI into their national health policies, for identification of the nutrient value, resulting in establishment of worldwide GI and glycemic load tables for specific food items. However, the apparent complexity of GI and lack of low GI meal choices need to be resolved in order to enhance patient’s quality of life, health and well-being. Low GI nutritional supplements, comprising of balanced proportion of carbohydrate, protein, BCAAs, fibers and micronutrients, may reduce the complexity related to dietary management of HD. The review summarizes the importance of nutritional management in HD with fo

关键词： Chronic Liver Disease Cirrhosis hepatogenous diabetes Low Glycemic Index Non-Alcoholic Fatty Liver Disease

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