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142 Further analyses of patients with severe albuminuria demonstrated comparable albuminuria-reducing effects between CCBs and ARB/ACEI

however, of those who showed glycemic control, there was a significantly lower incidence of hepatic encephalopathy.33 These two studies demonstrate that satisfactory glycemic control in cirrhotic patients can be achieved in only one third of cases by using current therapeutic schemes possibly because of hepatotoxicity, hypoglycemia and lactic acidosis, as most of antidiabetic drugs are metabolized in the liver.38 The recommendations of changes in diet and exercise regimens are empirical, as these measures have not been evaluated in patients with hepatic insufficiency

Gastroenterology 156 , 529533 (2019)