Liver transplantation improves cirrhosis-associated impaired oral glucose tolerance

Background. Thirty-five percent to 80% of cirrhotic patients have impaired glucose tolerance (IGT) or diabetes mellitus (DM), Diabetic cirrhotics have higher morbidity and mortality than nondiabetics. Therefore, it would be w orthwhile to determine whether liver transplantation improves glucose homeo stasis in these patients. Method. A total of 26 patients awaiting liver transplantation were evaluate d for impaired glucose homeostasis by fasting blood glucose and/or oral glu cose tolerance tests (OGTT), Five patients underwent transplant; surgery wi thin 1 year of OGTT and had a repeat OGTT 3-6 months after transplantation. Results. Sixty-five percent (17/26) of the patients had abnormal glucose ho meostasis, Twenty-three percent (6/26) met American Diabetes Association cr iteria for DM, and another 42.3% (11/26) had IGT. All patients had normal H bA(1)C levels. After transplantation, the 2-hr blood glucose improved in fo ur patients and the mean 2-hr glucose level was reduced (204+/-94 vs. 132+/ -53 mg/dl [mean+/-SD, P=0.051]). Conclusion. Liver transplantation can reverse cirrhosis-associated impaired glucose tolerance.