Case report reveals diabetic ketoacidosis as initial symptom of hepatogenous diabetes, suggesting new diagnostic considerations.
DKA can be the first clinical manifestation of hepatogenous diabetes, even in patients with normal HbA1C and no prior diabetes history. HbA1C is an unreliable marker for diagnosing diabetes in cirrhotic patients due to shortened red blood cell lifespan; OGTT should be considered when hepatogenous diabetes is suspected despite normal glycemic markers. Subclinical infections can precipitate DKA in cirrhosis through stress-induced insulin resistance.
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Albuni et al. (2026) studied this question.
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