Association of a history of type 2 diabetes with short-term mortality in patients with decompensated cirrhosis

Background The association between type 2 diabetes mellitus (T2DM) and mortality in patients with liver cirrhosis remains controversial. This study aimed to evaluate whether a history of T2DM influences short-term all-cause mortality in hospitalized patients with decompensated liver cirrhosis (DLC). Methods We conducted a retrospective study of hospitalized patients with DLC at three medical centers in China between November 2019 and June 2024. The study endpoint was the 6-month mortality. The association between T2DM and mortality was assessed using multivariable logistic regression, and stabilized inverse probability of treatment weighting (sIPTW) analysis was applied for sensitivity analysis. Results Among 984 eligible patients, 239 (24.3%) had a history of T2DM. Patients with T2DM were older and had a higher prevalence of hypertension and coronary artery disease; however, no significant difference in 6-month mortality was observed between patients with and without T2DM. Multivariable logistic regression showed no independent association between a history of T2DM and mortality (OR = 0.80, 95% CI: 0.51–1.23), this result remained consistent using sIPTW analysis (OR = 0.78, 95% CI: 0.51–1.21). Conclusions A history of T2DM may not be independently associated with short-term mortality in patients with DLC. These findings suggest that T2DM status may not be prioritized over liver-specific prognostic factors when assessing the short-term mortality risk in patients with DLC.