We 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.
In addition, as we noted, a patient with previous tight glucose control can lose control
as a result of an infection itself and potentially be mischaracterized as uncontrolled.To read this article in full you will need to make a payment
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References
- Uncontrolled diabetes mellitus and advanced cirrhosis.Dig Liver Dis. 2021; 53: 794
Nationwide Inpatient Sample (NIS), Healthcare cost and utilization project, Agency for Healthcare Research and Quality
- Uncontrolled diabetes mellitus increases risk of infection in patients with advanced cirrhosis.Dig Liver Dis. 2021; 53: 795
- Sodium-glucose cotransporter 2 inhibitors for type 2 diabetes: a systematic review and meta-analysis.Ann Intern Med. 2013; https://doi.org/10.7326/0003-4819-159-4-201308200-00007
- SGLT-2 inhibitors and the risk of lower-limb amputation: is this a class effect?.Diabetes, Obes Metab. 2018; https://doi.org/10.1111/dom.13255
Article info
Publication history
Published online: April 14, 2021
Accepted:
March 23,
2021
Received:
March 22,
2021
Footnotes
There was no funding provided for this response.
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Uncontrolled diabetes mellitus and advanced cirrhosisDigestive and Liver DiseaseVol. 53Issue 6
- PreviewRosenblatt 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.
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- Uncontrolled diabetes mellitus increases risk of infection in patients with advanced cirrhosisDigestive and Liver DiseaseVol. 53Issue 4
