ArticleDigestive diseases and sciences2018
Hemoglobin A1c Has Suboptimal Performance to Diagnose and Monitor Diabetes Mellitus in Patients with Cirrhosis.
Article in Digestive diseases and sciences, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 19 citations in OpenAlex.
- Hepatogenous diabetes in the era of precision medicine: diagnosis, management, and future directions.Clinical and experimental medicine · 2026Review
- Innovative Drugs First Implemented in Type 2 Diabetes Mellitus and Obesity and Their Effects on Metabolic Dysfunction-Associated Steatohepatitis (MASH)-Related Fibrosis and Cirrhosis.Journal of clinical medicine · 2025Review
- Glycemic Control Is Associated with Histological Findings of Nonalcoholic Fatty Liver Disease.Diabetes & metabolism journal · 2024Observational
- From liver to hormones: The endocrine consequences of cirrhosis.World journal of gastroenterology · 2024Review
- Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A State-of-the-Art Review.Journal of obesity & metabolic syndrome · 2023Review
- Endocrinology for the hepatologist.Clinical liver disease · 2023Article
- Optimal glycated hemoglobin A1c value for prediabetes and diabetes in patients with pancreatic diseases.Frontiers in endocrinology · 2023Article
- [Expert consensus on the management of diabetes mellitus in patients with liver cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2022Article
- Fatty Liver Disease: Diagnosis and Stratification.Annual review of medicine · 2022Review
- Clinical implications, diagnosis, and management of diabetes in patients with chronic liver diseases.World journal of hepatology · 2020Review
- Non-invasive diagnosis: non-alcoholic fatty liver disease and alcoholic liver disease.Translational gastroenterology and hepatology · 2020Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGlycated hemoglobin A1c (HbA1c) is routinely used to diagnose and monitor type 2 diabetes mellitus (T2DM) in cirrhotic patients. Remarkably, HbA1c may be falsely low in such patients.
aimsWe assessed the diagnostic and monitoring yield of HbA1c in cirrhotic patients with T2DM (DM-Cirr) and without T2DM (NoDM-Cirr).
methodsWe conducted a composite study allocating 21 NoDM-Cirr into a cross-sectional module and 16 DM-Cirr plus 13 controls with T2DM only (DM-NoCirr) into a prospective cohort. Oral glucose tolerance test (OGTT) was performed in NoDM-Cirr. DM-Cirr and DM-NoCirr were matched by sex, age, BMI, and T2DM treatment and studied with continuous glucose monitoring (CGM). Percent deviations from target, low/high blood glucose indexes (LBGI/HBGI) were calculated from CGM, as well as the average daily risk range (ADRR) as a marker of glucose variability.
resultsOverall, HbA1c and OGTT diagnostic yield agreed in 12 patients (57%, ρ = 0.45, p < 0.03). CGM captured 3463 glucose determinations in DM-Cirr and 4273 in DM-NoCirr (p = 0.42). Regression analysis showed an inferior association between HbA1c and CGM in DM-Cirr (R
conclusionHbA1c inaccurately represents chronic glycemia in patients with cirrhosis, likely in relation to increased glucose variability.
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