Continuation of metformin use after a diagnosis of cirrhosis significantly improves survival of patients with diabetes

摘要: The risks and benefits of metformin use in patients with cirrhosis diabetes are debated. Although data on a protective effect against liver cancer development have been reported, is frequently discontinued once diagnosed because concerns about an increased risk adverse effects impairment. This study investigated whether continuation after diagnosis improves survival diabetes. Diabetic between 2000 2010 who were at the time identified (n = 250). Data retrospectively abstracted from medical record. Survival continued versus was compared using log-rank test. Hazard ratio (HR) 95% confidence interval (CI) calculated Cox's proportional hazards analysis. Overall, 172 whereas 78 metformin. Patients had significantly longer median than those (11.8 vs. 5.6 years overall, P < 0.0001; 11.8 6.0 for Child A patients, 0.006; 7.7 3.5 B/C 0.04, respectively). After adjusting other variables, remained independent predictor better survival, HR 0.43 (95% CI: 0.24-0.78; 0.005). No developed metformin-associated lactic acidosis during follow-up. Conclusion: Continuation reduced death by 57%. Metformin should therefore be diabetic if there no specific contraindication. (Hepatology 2014;60:2007–2015)