A totally new flowchart has been set by international associations, and the new schedule is progressively being accepted in clinical practice.30 Excluding the very few patients with type 1 diabetes, where intensified insulin treatment remains the only possible option, the old criterion that insulin should be the treatment of choice for patients with cirrhosis has been progressively challenged by evidence that old and new antidiabetic drugs are safely used outside decompensated cirrhosis. Here, INS is linked to Cirrhosis.