Metformin Can Help Diabetic Patients With Cirrhosis Live Longer

What is Cirrhosis?

Cirrhosis is a medical condition wherein there is irreversible scarring of the liver caused by factors such as excessive consumption of alcohol, viral hepatitis B and C, and fatty liver disease. It can give rise to signs and symptoms such as yellowing of the eyes, skin and tongue, a condition known as jaundice. It can also lead to a feeling of unexplained fatigue and itching of the skin. In patients who have long-term cirrhosis, the liver is continuously damaged over time. Scar tissue builds up in the liver, so that the liver is unable to perform its normal bodily functions. Scarred tissue can block blood flow to the liver. Cirrhosis may develop slowly all throughout the years, further compromising the normal functioning of the liver.

We know that the liver is an important organ in the body because it performs several important functions such as the detoxification of harmful substances in the body as well as in the production of important nutrients which are essential for bodily function. Cirrhosis may gradually develop over time; while mild, the liver is able to repair itself and function normally. However if cirrhosis goes far advanced, more scar tissue forms in the liver and the resultant liver damage cannot be repaired. Initially in the mild stages of liver cirrhosis, there may be no signs and symptoms; however as the disease progresses, there may be blood capillaries that appear visible on the skin on the upper abdomen. Other signs and symptoms include fatigue, insomnia, itchy skin, loss of appetite, loss of body weight, nausea, pain or tenderness in the area where the liver is located, red or blotchy palms and weakness. The abdomen may become filled with fluid, a condition known as ascites. There may be a fast heartbeat, personality changes due to toxin buildup in the brain, bleeding gums, loss of muscle mass, difficulty in processing drugs in the liver, confusion, dizziness, fluid buildup in the arms and legs or edema, hair loss, easy bruising, jaundice or yellowish discoloration of the skin and eyes, memory problems, fever, muscle cramps, nosebleeding, right shoulder pain, black and tarry stools, vomiting of blood, darker urine, and gait problems.

Cirrhosis can be caused by long-term alcohol abuse, hepatitis B and C infection, and fatty liver disease. Excessive alcohol consumption is defined as drinking alcohol for more than 21 units in men and drinking of more than 14 units per week in women. Too much alcohol consumption can lead to liver damage. Hepatitis C infection can also lead to cirrhosis, as well as hepatitis B and D. Non-alcoholic steatohepatitis (NASH) occurs in people who are obese, diabetes patients, those with high blood lipid (fat) levels, as well as individuals with hypertension (high blood pressure). Excess fat in the body and in the liver as well can cause inflammation and scarring, resulting in possible cirrhosis later on. Autoimmune hepatitis can result from the attack of the person's own immune system against healthy cells. Genetic conditions such as hemochromatosis and Wilson’s disease can also lead to cirrhosis. Blockage of bile ducts as a result of cancer of the bile ducts or cancer of the pancreas can block the bile ducts, increasing the risk of cirrhosis. Other conditions that can increase the risk for cirrhosis include Budd-Chiari syndrome, cystic fibrosis, primary sclerosing cholangitis, galactosemia, schistosomiasis, biliary atresia and glycogen storage disease.

Metformin Can Help Diabetic Patients With Cirrhosis Live Longer

A recent study has shown that continuation of metformin after a cirrhosis diagnosis improved survival rates among diabetes patients. Before, doctors usually discontinue metformin once cirrhosis is diagnosed because of concerns about an increased risk of adverse effects in patients with liver problems. However the results of this study proved otherwise. In this study, about 172 patients continued taking metformin, while another 78 individuals discontinued metformin after cirrhosis diagnosis. Patients who continued taking metformin had longer survival as compared to those who discontinued metformin use. No patient developed lactic acidosis, a common side effect among patients with liver cirrhosis. This study, done by researchers from Mayo clinic, was published in the journal Hepatology.

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