Is insulin the preferred treatment in persons with type 2 diabetes and liver cirrhosis?

被引：20

作者：

Yen, Fu-Shun ^{[1
]}

Lai, Jung-Nien ^{[2
,3
]}

Wei, James Cheng-Chung ^{[4
,5
,6
]}

Chiu, Lu-Ting ^{[7
,8
]}

Hsu, Chih-Cheng ^{[9
,10
,11
]}

Hou, Ming-Chih ^{[12
,13
]}

Hwu, Chii-Min ^{[12
,14
]}

机构：

[1] Dr Yens Clin, 15 Shanying Rd, Taoyuan 33354, Taiwan

[2] China Med Univ, Coll Chinese Med, Sch Chinese Med, 91 Hsueh Shih Rd, Taichung 40402, Taiwan

[3] China Med Univ Hosp, Dept Chinese Med, 3E 373-2 Jianxing Rd, Taichung 40459, Taiwan

[4] Chung Shan Med Univ Hosp, Dept Allergy Immunol & Rheumatol, Taichung 40201, Taiwan

[5] Chung Shan Med Univ, Inst Med, Taichung 40201, Taiwan

[6] China Med Univ, Grad Inst Integrated Med, 110 Sec 1,Jianguo N Rd, Taichung 40201, Taiwan

[7] China Med Univ Hosp, Management Off Hlth Data, 3F 373-2 Jianxing Rd, Taichung 40459, Taiwan

[8] China Med Univ, Coll Med, 110 Sec 1,Jianguo N Rd, Taichung 40201, Taiwan

[9] Natl Hlth Res Inst, Inst Populat Hlth Sci, 35 Keyan Rd, Miaoli 35053, Taiwan

[10] China Med Univ, Dept Hlth Serv Adm, 91 Hsueh Shih Rd, Taichung 40402, Taiwan

[11] Min Sheng Gen Hosp, Dept Family Med, 168 ChingKuo Rd, Taoyuan 33044, Taiwan

[12] Natl Yang Ming Univ, Fac Med, Sch Med, 155 Sec 2,Linong St, Taipei 11221, Taiwan

[13] Taipei Vet Gen Hosp, Dept Med, Div Gastroenterol & Hepatol, 201 Sec 2,Shipai Rd, Taipei 11217, Taiwan

[14] Taipei Vet Gen Hosp, Sect Endocrinol & Metab, Dept Med, 201 Sec 2,Shipai Rd, Taipei 11217, Taiwan

来源：

BMC GASTROENTEROLOGY | 2021年 / 21卷 / 01期

关键词：

All-cause mortality; Hepatocellular carcinoma; Hepatic failure; Decompensated cirrhosis; Hypoglycemia; ALL-CAUSE MORTALITY; CLINICAL-IMPLICATIONS; RISK; MELLITUS; COMPLICATIONS; PEOPLE;

D O I：

10.1186/s12876-021-01773-x

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background Insulin is highly recommended for diabetes management in persons with liver cirrhosis. However, few studies have evaluated its long-term effects in these persons. We conducted this study to compare the risks of mortality, liver-related complications, and cardiovascular events in persons with type 2 diabetes mellitus (T2DM) and compensated liver cirrhosis. Methods From January 1, 2000, to December 31, 2012, we selected 2047 insulin users and 4094 propensity score-matched nonusers from Taiwan's National Health Insurance Research Database. Cox proportional hazard models were used to assess the risks of outcomes. Results The mean follow-up time was 5.84 years. The death rate during the follow-up period was 5.28 and 4.07 per 100 person-years for insulin users and nonusers, respectively. In insulin users, the hazard ratios and 95% confidence intervals (CIs) of all-cause mortality, hepatocellular carcinoma, decompensated cirrhosis, hepatic failure, major cardiovascular events, and hypoglycemia were 1.31 (1.18-1.45), 1.18 (1.05-1.34), 1.53 (1.35-1.72), 1.26 (1.42-1.86), 1.41 (1.23-1.62), and 3.33 (2.45-4.53), respectively. Conclusions This retrospective cohort study indicated that among persons with T2DM and compensated liver cirrhosis, insulin users were associated with higher risks of death, liver-related complications, cardiovascular events, and hypoglycemia compared with insulin nonusers.

引用

页数：9

共 31 条

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