Rosenblatt and colleagues recently published an attractive research paper on uncontrolled
diabetes mellitus (DM) and the risk of infection in patients with advanced cirrhosis
[
[1]
]. In this study, the authors found that uncontrolled DM was associated with an increased
risk of infection, after controlling for potential confounders. In addition, the combination
of uncontrolled DM and elderly age could significantly improve the predictive value
of mortality in cirrhosis patients. There is no doubt that the findings of this study
will help clinicians pay more attention to the glycemic control of cirrhosis patients,
so as to better refine the risk classification. However, a clear explanation of the
following concerns will help to better interpret the paper's conclusions.To read this article in full you will need to make a payment
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References
- Uncontrolled diabetes mellitus increases risk of infection in patients with advanced cirrhosis.Dig Liver Dis. 2021; 53: 445-451
- The probability of A1C goal attainment in patients with uncontrolled type 2 diabetes in a large integrated delivery system: a prediction model.Diabetes Care. 2020; 43: 1910-1919
- Effect of two periodontal treatment modalities in patients with uncontrolled type 2 diabetes mellitus: a randomized clinical trial.J Clin Periodontol. 2018; 45: 1098-1106
- Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the diabetes prevention program outcomes study.Lancet Diabetes Endocrinol. 2015; 3: 866-875
- Anti-inflammatory effects of metformin irrespective of diabetes status.Circ Res. 2016; 119: 652-665
- Protective effect of metformin against tuberculosis infections in diabetic patients: an observational study of south Indian tertiary healthcare facility.Braz J Infect Dis. 2017; 21: 312-316
Article info
Publication history
Published online: April 08, 2021
Accepted:
March 16,
2021
Received:
March 10,
2021
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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- Uncontrolled diabetes mellitus increases risk of infection in patients with advanced cirrhosisDigestive and Liver DiseaseVol. 53Issue 4
- Reply to “Uncontrolled diabetes mellitus and advanced cirrhosis”Digestive and Liver DiseaseVol. 53Issue 6
- PreviewWe appreciate the thoughtful letter from Dr. Zong [1]. While the use of large databases brings significant advantages, there are noteworthy limitations. The most prominent advantage is certainly the enormous power and sample size. Equally important, the Nationwide Inpatient Sample [2], the database utilized in our analysis, provides a nationally representative cohort by sampling hospitals and patients across the United States. However, as discussed in our limitations section [3], we relied on diagnosis codes for the definition of controlled and uncontrolled diabetes.
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