Liver cirrhosis is frequently associated with diabetes mellitus (DM), and this
metabolic complication is also frequent after orthotopic liver transplantation
(OLT). The aim of our study is to investigate which factors are associated with
DM before and after OLT and their impact on post-OLT evolution. We evaluated the
prevalence of DM among 115 liver transplant candidates with cirrhosis and
assessed their evolution after OLT (median follow-up, 41 months). Sixteen
candidates had DM requiring pharmacological therapy (group A), 45 candidates had
DM controlled with diet (group B), and 54 candidates did not have DM (group C).
One-year and 3-year actuarial survival rates were 100% and 100% for group A, 91%
and 85% for group B, and 77% and 74% for group C, respectively (P <.03). Post-OLT
DM was more frequent in group A. The incidence of other metabolic complications,
major infections, rejection, and arterial hypertension; the need for
hospitalization; and renal and graft function of patients in groups A, B, and C
were similar. The only risk factor for DM 1 year after OLT on multivariate
analysis was pre-OLT DM requiring pharmacological treatment. The incidence of
complications, need for hospitalization, and renal and graft function 1 year
after OLT for patients with post-OLT DM were similar to those of patients without
post-OLT DM. In conclusion, patients with cirrhosis who have DM have a greater
risk for post-OLT DM, but their midterm survival is not worse than the survival
of those without DM