Association of a history of type 2 diabetes with short-term mortality in patients with decompensated cirrhosis.

Background: The association between type 2 diabetes mellitus (T2DM) and mortality in patients with liver cirrhosis remains controversial. This study aimed to evaluate whether a history of T2DM influences short-term all-cause mortality in hospitalized patients with decompensated liver cirrhosis (DLC). Methods: We conducted a retrospective study of hospitalized patients with DLC at three medical centers in China between November 2019 and June 2024. The study endpoint was the 6-month mortality. The association between T2DM and mortality was assessed using multivariable logistic regression, and stabilized inverse probability of treatment weighting (sIPTW) analysis was applied for sensitivity analysis. Results: Among 984 eligible patients, 239 (24.3%) had a history of T2DM. Patients with T2DM were older and had a higher prevalence of hypertension and coronary artery disease; however, no significant difference in 6-month mortality was observed between patients with and without T2DM. Multivariable logistic regression showed no independent association between a history of T2DM and mortality (OR = 0.80, 95% CI: 0.51-1.23), this result remained consistent using sIPTW analysis (OR = 0.78, 95% CI: 0.51-1.21). Conclusions: A history of T2DM may not be independently associated with short-term mortality in patients with DLC. These findings suggest that T2DM status may not be prioritized over liver-specific prognostic factors when assessing the short-term mortality risk in patients with DLC.