Promoting a healthy lifestyle, managing hyperlipidemia, diabetes mellitus, hypertension, and immunizations in patients with cirrhosis

Maximizing the general well-being of the patient with cirrhosis is an ongoing challenge, with limited information about the optimal approach. In this chapter, we discuss the management of some common comorbid conditions, including diabetes mellitus (DM), hypertension, and hyperlipidemia. We also review the approach to weight loss and exercise, as obesity and decreased physical fitness are significant concerns in this population and can have major negative consequences, including increased operative risk, higher rates of decompensation, and hepatocellular cancer. Finally, we summarize the current recommendations for vaccinations, an important component in the primary care of the patient with cirrhosis.