Liver plays a crucial role in glucose homeostasis. Type 2 diabetes mellitus (T2DM) is often associated with cirrhosis. Both conditions are related in metabolic associated steatotic liver disease (MASLD), the leading cause of chronic liver disease. Having diabetes as comorbidity increase the risk of cirrhosis-related complications, such as hepatocellular karcinóma (HCC) and overall mortality. Patients with type 2 diabetes should be systematically screened for MASLD-related fibrosis with noninvasive tools using FIB-4 score and transient elastography. Early diagnosis of diabetes in patients with cirrhosis is crucial for finding the optimal management strategy. Using HbA_1c for the diagnosis of diabetes in patients with cirrhosis can be misleading, especially in Child–Pugh B-C stage, while anemia may turn the test unreliable. In decompensated cirrhosis the only recommended treatment for diabetes is insulin, however clinicians must be aware of higher risk of hypoglycaemia. Patient care should be based on a multidisciplinary approach, includ­ing endocrinologists, hepatologists, nutritionists and physiotherapists, while the treatment should be personalized, based on risk-benefit evaluation. In the present review authors summarize the association between diabetes and liver disease, demonstrate the main pathomechanisms, draw attention to special diagnostic aspects and also muster the currently available antidiabetics in the chronic liver disease.

This review about advanced biliary cannulation, provides a comprehensive overview of endoscopic retrograde cholangiopancreatography (ERCP) salvage cannulation techniques, focusing on strategies for managing difficult biliary cannulation. In this review we integrated the theoretical knowledge with practical applications, supported by numerous research and evidence based clinical studies and guidelines to present the current optimal approach of salvage ERCP techniques in patients with difficult biliary cannulation.