The goal of this observational study is to establish risk factors for post-transplant in adult individuals with cirrhosis without diabetes undergoing liver transplant evaluation.
The question being addressed is: can laboratory work, anthropometric tests, functional tests, imaging, and advanced measurements such as wrist actigraphy, continuous glucose monitoring, or oral glucose tolerance testing predict the development of diabetes after liver transplant?
Participants will be asked to periodically participate in wearing a continuous glucose monitor and wrist actigraph and obtain an oral glucose tolerance test both before and after liver transplant.
Patients presenting to liver transplant clinic with a diagnosis of cirrhosis.
Age >18 yrs.
Ability to understand and sign written consent form, or have a legally-authorized representative or proxy who can be approached for consent
Patients without consent
Patients with implantable cardioverter defibrillator devices or automated implantable cardioverter defibrillator devices will be excluded from the bio-electrical impedance analysis portion of the measurements.
Patients with unremovable electrical medical devices or devices that cannot turn off will be excluded from the bio-electrical impedance analysis measurements
Pregnant patients
Individuals with cirrhosis undergoing evaluation for liver transplant
Cohort
Prospective
Not listed
Early post-transplant hyperglycemia
Blood sugars above 200 mg/dL or requiring insulin therapy
Post-transplant diabetes
Hemoglobin A1c \> 6.5% or two-hour glucose from an oral glucose tolerance test ≥ 200 mg/dL after liver transplant
Undiagnosed diabetes in cirrhosis
Two-hour glucose in an oral glucose tolerance test ≥ 200 mg/dL in an individual with cirrhosis with a hemoglobin A1c less than 6.5%
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