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

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.