Glucose and insulin metabolism in cirrhosis

Alexander S. Petrides, Ralph A. DeFronzo

Research output: Contribution to journalReview articlepeer-review

126 Scopus citations


Glucose intolerance, overt diabetes mellitus. and insulin resistance are characteristic features of patients with cirrhosis. Insulin secretion, although increased in absolute terms, is insufficient to offset the presence of insulin resistance. The defect in insulin-mediated glucose disposal involves peripheral tissues, primarily muscle, and most likely reflects a disturbance in glycogen synthesis Hepatic glucose production is normally sensitive to insulin; at present, it is unknown whether hepatic glucose uptake is impaired in cirrhosis. One of the more likely candidates responsible for the insulin-resistant state is insulin itself. The hyperinsulinemia results from three abnormalities: dimimshed hepatic extraction, portosystemic/intrahepatic shunting, and enhanced insulin secretion.

Original languageEnglish (US)
Pages (from-to)107-114
Number of pages8
JournalJournal of Hepatology
Issue number1
StatePublished - Jan 1989
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology


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