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Is insulin the preferred treatment in persons with type 2 diabetes and liver cirrhosis?
- Source :
- BMC Gastroenterology, BMC Gastroenterology, Vol 21, Iss 1, Pp 1-9 (2021)
- Publication Year :
- 2020
- Publisher :
- Authorea, Inc., 2020.
-
Abstract
- 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.
- Subjects :
- Liver Cirrhosis
medicine.medical_specialty
Cirrhosis
Hepatocellular carcinoma
medicine.medical_treatment
030209 endocrinology & metabolism
Decompensated cirrhosis
RC799-869
Type 2 diabetes
Hypoglycemia
03 medical and health sciences
0302 clinical medicine
Diabetes management
Internal medicine
medicine
Humans
Hypoglycemic Agents
Insulin
Proportional Hazards Models
Retrospective Studies
Hepatic failure
business.industry
Mortality rate
Research
Liver Neoplasms
Hazard ratio
Gastroenterology
Type 2 Diabetes Mellitus
Retrospective cohort study
General Medicine
Diseases of the digestive system. Gastroenterology
All-cause mortality
medicine.disease
Diabetes Mellitus, Type 2
030211 gastroenterology & hepatology
business
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- BMC Gastroenterology, BMC Gastroenterology, Vol 21, Iss 1, Pp 1-9 (2021)
- Accession number :
- edsair.doi.dedup.....5d28501eea43ed40b7e648504e94e412