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Although low frequency of cardiovascular complications have been reported,9,1417 two recent publications found that patients with chronic hepatitis C showed an increase of carotid intimal layer thickness, the number of carotid plaques and the extent of atherosclerosis compared with control subjects.2427 In another study, the prevalence of non-obstructive coronary artery disease was similar in cirrhotic and non-cirrhotic individuals and it was associated with traditional risk factors, particularly DM.28 The impact of DM also extends to immunocompetence, and can increase the risk of severe infection, such as spontaneous bacterial peritonitis.29 Cirrhotic patients with such infections exhibit liver failure and hepatorenal syndrome, and have a high hospital mortality.30 Treatment of DM in Patients with Chronic Liver Disease The effective control of hyperglycemia may reduce complications and mortality rate in patients with DM and chronic liver disease

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Arksey H, OMalley L