How do I manage both T2D and liver cirrhosis together at 52?

Question

Hello doctor,

I am a 62-year-old male with a long-standing history of type 2 diabetes and was recently diagnosed with liver cirrhosis due to non-alcoholic steatohepatitis (NASH). My diabetes has been managed with oral medications, but my HbA1c is 7.9 %, and I am concerned about the impact of my liver condition on diabetes management.

My liver function tests show elevated bilirubin (2.5 mg/dL (milligrams per deciliter) and low albumin (2.8 g/dL (grams per deciliter), and my physician mentioned that certain diabetes medications may not be safe due to cirrhosis. I am struggling with fatigue and worried about worsening liver function while keeping my blood sugar under control.

Are there specific diabetes treatments that are safer for someone with cirrhosis, and how can I balance managing both conditions effectively?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Cirrhosis and diabetes are chronic diseases that are closely linked and can significantly impact quality of life. Diabetes is a risk factor for liver cirrhosis, which is a diabetogenic condition. Cirrhosis can cause diabetes, which is known as hepatogenous diabetes. Diabetes increases the risk of complications and mortality in patients with cirrhosis.

Here are some other things to know about cirrhosis and diabetes:

1. Cirrhosis is a significant cause of death in diabetes.

2. Impaired glucose tolerance is seen in about 60 % of patients with cirrhosis.

3. Insulin resistance is a factor in the development of diabetes in liver disease.

4. Hepatogenous diabetes is clinically different from type 2 diabetes.

5. Patients with cirrhosis and diabetes frequently die of liver-related causes.

6. Diabetes can increase the risk of severe infection in patients with cirrhosis.

I hope this helps.

Thank you and take care.

Regards.