The effect of type 2 diabetes mellitus on spontaneous bacterial peritonitis among patients with decompensated liver cirrhosis

Abstract

Abstract Background Type 2 diabetes mellitus (T2DM) is a common comorbidity among liver cirrhosis cases. However, there are few data indicating the effect of DM on spontaneous bacterial peritonitis (SBP). Aim To evaluate the effect of DM and glycosylated hemoglobin A1c (HbA1c) values on the prevalence of SBP in cases with liver cirrhosis and ascites. Patients and methods A total of 120 cases with liver cirrhosis and ascites were evaluated. The presence of DM and HbA1c was measured at the time of the first paracentesis. Cases were followed for 1 year. SBP development was the primary outcome. Results During follow-up, DM cases had an elevated chance of developing SBP [hazard ratio (HR): 1.767; P=0.026]. Cases with HbA1c values more than or equal to 8.5% had a greater risk for development SBP within 90 days than DM cases with values less than 8.5% (HR: 1.478; P=0.271). Cases with HbA1c values more than or equal to 8.5% had a greater chance of getting SBP within 90 days than non-DM cases (HR: 1.738; P=0.119). DM cases with HbA1c values less than 8.5% had an increased chance of having SBP within 90 days than non-DM cases (HR: 1.188; P=0.687). Conclusions Cases with both liver cirrhosis and T2DM have an increased chance of developing SBP. HbA1c readings may be beneficial for stratifying the risk of SBP among DM cases, hence identifying individuals who might benefit from antibiotic prophylaxis.