Autoimmune liver diseases and diabetes.

Abstract

Autoimmune liver diseases include autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis. They are chronic, heterogenous diseases affecting the liver which is a key metabolic organ that ensures glucose homeostasis. It is well known that patients with other chronic liver diseases such as cirrhosis and nonalcoholic fatty liver disease (NAFLD) display glucose disturbances like insulin resistance and have an increased risk of diabetes. Previous evidence on glucose disturbances in patients with autoimmune liver disease is scarce but does point towards a potentially increased risk of type 1 diabetes and type 2 diabetes. The underlying mechanisms are unknown but may reflect genetic predisposition, concurrent NAFLD and or cirrhosis development, and treatment (steroid) related impairment of glucose homeostasis. Therefore, increased awareness and surveillance of diabetes development in patients with autoimmune liver disease may be important. Overall, detection and treatment of diabetes generally follow the usual diabetes guidelines; however, in patients with advanced liver cirrhosis, HbA1c may not be a reliable marker of average glucose levels, and treatment with insulin is generally recommended. In addition, it has recently been suggested that sodium-glucose cotransporter 2 inhibitors may be beneficial in treating refractory ascites. Further research on diabetes risk in autoimmune liver disease is warranted.

• Authors: Anne-Sofie H Jensen, Henriette Ytting, Marie Winther-Sørensen, Johan Burisch, Annika Bergquist, Lise Lotte Gluud, Nicolai J Wewer Albrechtsen
• Journal: European journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 35 Issue 9 Pg. 938-947 (09 01 2023) ISSN: 1473-5687 [Electronic] England
• PMID: 37505973 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Chemical References

• Glucose

Topics

• Humans
• Non-alcoholic Fatty Liver Disease (complications)
• Diabetes Mellitus, Type 2 (complications, diagnosis, epidemiology)
• Liver Cirrhosis, Biliary (etiology)
• Cholangitis, Sclerosing (complications)
• Liver Diseases (diagnosis, epidemiology, etiology)
• Autoimmune Diseases (complications, diagnosis, drug therapy)
• Hepatitis, Autoimmune (complications, diagnosis, drug therapy)
• Chronic Disease
• Liver Cirrhosis (complications)
• Glucose
• Liver