April - June 2011, Volume 7, Issue 2

Jang HW, Hong WJ, Kim MK, Jeong IS, Kim KS, Kim HJ, Ku BJ

Nateglinide for Diabetic Patients with Liver Cirrhosis

Acta Endo (Buc) 2011, 7 (2): 229-238
doi: 10.4183/aeb.2011.229

Purpose. About 30% of patients with liver cirrhosis have diabetes. Postprandial hyperglycemia is more problematic than fasting hyperglycemia when managing diabetic patients with cirrhosis. Nateglinide decreases in the mealtime plasma glucose levels. The present study aims to determine\r\nwhether nateglinide is suitable for the management of diabetic patients with liver cirrhosis.\r\nMethods. This was a retrospective analysis of the cirrhotic patients who were treated at CNUH between Jan 2003 and Dec\r\n2009. A total of 81 Child-Pugh Class A or B patients who had been treated with insulin (I, n=27) or nateglinide (N, n=27) for at least 12 months were included in the study, while 27 cirrhotic patients without diabetes (C, n=27) were included as a control group. We compared the efficacy of treatment and the safety between the groups.\r\nResults. The basal mean HbA1c level was higher in the insulin treatment group than that in the nateglinide treatment group. The mean HbA1c was lowered in thepatients treated with insulin (9.36 ? 1.71% → 7.69?1.52%, p=0.026), but this was not changed in the patients treated with\r\nnateglinide (8.01?2.37 % → 7.78?2.11%, p=0.692) after 12 months treatment. There was no change in the Child-Pugh score in all the groups.\r\nConclusion. In case of mild hyperglycemia, nateglinide may be used for glycemic control in diabetic patients with\r\ncirrhosis as an insulin substitute without worsening the state of liver cirrhosis.

Keywords: Nateglinide, diabetes mellitus, liver cirrhosis

Correspondence: Bon Jeong Ku, Department of Internal Medicine, Chungnam National University School of Medicine, 33 Munhwa-ro, Jung-gu, Daejeon 301721 Korea , Tel: +82-42-280-7149, Fax: +82-\r\n42-280-7995, E-mail: bonjeong@cnu.ac.kr