Hepatic complications of type 1 diabetes mellitus in children. A review

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Abstract

The prevalence of liver disease among patients with diabetes mellitus (DM) is estimated to range from 17% to 100%, depending on the selected diagnostic criteria. Hepatic complications of type 1 DM (DM 1) include metabolic dysfunction-associated steatotic liver disease (MASLD) and glycogenic hepatopathy as variants of storage diseases, as well as diabetic hepatosclerosis as a manifestation of liver microangiopathy. The most common hepatic complication of DM 1 is MASLD, which is associated with a further deterioration in glycemic control and the development of liver fibrosis. The “gold standard” for the diagnosis of MASLD, glycogen hepatopathy, and diabetic hepatosclerosis is a morphological examination of a liver biopsy specimen. The main method of prevention and treatment of hepatic complications of DM 1 is the optimal control of blood glucose based on the target level of glycated hemoglobin, as well as control of hyperglycemia episodes based on continuous blood glucose monitoring. The question of the need to use hepatoprotectors for hepatic complications of DM 1 remains open, since there are no relevant clinical guidelines. Practitioners should be aware of the hepatic complications of DM 1 in children for prevention, early diagnosis, and timely treatment of these diseases.

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Svetlana N. Borzakova

Bashlyaeva Children's City Clinical Hospital; Russian Medical Academy of Continuous Professional Education; Research Institute for Healthcare Organization and Medical Management

Author for correspondence.
Email: borzakovasn@zdrav.mos.ru
ORCID iD: 0000-0001-5544-204X

Cand. Sci. (Med.)

Russian Federation, Moscow; Moscow; Moscow

Ismail M. Osmanov

Bashlyaeva Children's City Clinical Hospital

Email: borzakovasn@zdrav.mos.ru
ORCID iD: 0000-0003-3181-9601

D. Sci. (Med.), Prof.

Russian Federation, Moscow

Irina G. Kolomina

Bashlyaeva Children's City Clinical Hospital

Email: borzakovasn@zdrav.mos.ru

Department Head

Russian Federation, Moscow

Irina N. Zakharova

Russian Medical Academy of Continuous Professional Education

Email: borzakovasn@zdrav.mos.ru
ORCID iD: 0000-0003-4200-4598

D. Sci. (Med.), Prof.

Russian Federation, Moscow

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2. Fig. 1. Echographic pattern of the liver parenchyma compared to the kidney parenchyma: a – with poor control of diabetes mellitus; b – after improvement of glycemic control [6].

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3. Fig. 2. Histological examination of the liver [26].

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4. Fig. 3. Computed tomography: a – transverse sections; b – longitudinal sections of computed tomographic angiography showing hepatomegaly in a patient with glycogen hepatopathy [26].

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5. Fig. 4. Arterioles of the liver parenchyma in health and liver arteriolosclerosis [17], explanations in the text.

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