Clinical implications of diabetes in chronic liver disease: Diagnosis, outcomes and management, current and future perspectives

doi:10.3748/wjg.v28.i8.775

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Feb 28, 2022 (publication date) through Nov 25, 2024

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Feb 28, 2022; 28(8): 775-793
Published online Feb 28, 2022. doi: 10.3748/wjg.v28.i8.775

Table 5 Use of anti-hyperglycaemic agents in cirrhotic individuals according to Child-Pugh class[102]

Drug	Child-Pugh class A	Child-Pugh class B	Child-Pugh class C
Short-acting insulins
Human	Allowed	Allowed	Allowed (dose reduction)
Lyspro	Allowed	Allowed	Allowed
Aspart	Allowed	Allowed	Allowed
Glulisine	Allowed	Allowed	Allowed
Long-acting insulins
Human-NPH	Allowed	Allowed	Allowed (dose reduction)
Glargine	Allowed	Allowed	Allowed
Levemir	Allowed	Allowed	Allowed
Degludec	Allowed	Allowed	Allowed
Glargine-300	Allowed	Allowed	Allowed
Sulfonylureas
Glibenclamide	Not recommended	Contraindicated	Contraindicated
Glimepiride	Allowed (caution)	Not recommended	Contraindicated
Gliclazide	Allowed (caution)	Not recommended	Contraindicated
Glipizide	Allowed (caution)	Not recommended	Contraindicated
Meglitinides
Repaglinide	Allowed (caution)	Not recommended	Contraindicated
Biguanides
Metformin	Allowed	Allowed (dose reduction)	Contraindicated
Thiazolidinediones
Pioglitazone	Allowed	Contraindicated	Contraindicated
DPP-4 inhibitors
Sitagliptin	Allowed	Allowed	Contraindicated
Vildagliptin	Contraindicated	Contraindicated	Contraindicated
Saxagliptin	Allowed	Allowed	Contraindicated
Linagliptin	Allowed	Allowed	Contraindicated
Alogliptin	Allowed	Allowed	Contraindicated
GLP-1RAs
Exenatide	Allowed	Contraindicated	Contraindicated
Liraglutide	Allowed	Contraindicated	Contraindicated
Lixisenatide	Allowed	Allowed	Contraindicated
Exenatide LAR	Allowed	Allowed	Contraindicated
Dulaglutide	Allowed	Allowed	Contraindicated
Semaglutide	Allowed	Allowed	Contraindicated
α-glicosidase inhibitors
Acarbose	Allowed	Allowed (caution)	Contraindicated
SGLT2 inhibitors
Dapaglifozin	Allowed	Allowed	Contraindicated
Canaglifozin	Allowed	Allowed	Contraindicated
Empaglifozin	Allowed	Allowed	Contraindicated
Ertugliflozin	Allowed	Allowed	Contraindicated

DPP-4: Dipeptidyl peptidase 4; GLP-1 RAs: Glucagon-like peptide 1 receptor agonists; SGLT2: Sodium-glucose cotransporter 2; NPH: Neutral protamine Hagedorn; LAR: Long-acting release.

Citation: García-Compeán D, Orsi E, Kumar R, Gundling F, Nishida T, Villarreal-Pérez JZ, Del Cueto-Aguilera ÁN, González-González JA, Pugliese G. Clinical implications of diabetes in chronic liver disease: Diagnosis, outcomes and management, current and future perspectives. World J Gastroenterol 2022; 28(8): 775-793
URL: https://www.wjgnet.com/1007-9327/full/v28/i8/775.htm
DOI: https://dx.doi.org/10.3748/wjg.v28.i8.775