['Diabetes mellitus (DM) is identified as a negative prognostic indicator in hepatocellular carcinoma (HCC).', 'A retrospective review of HCC patients was conducted to assess the effect of DM on clinical variables.', 'Ninety-seven of 265 (34%) patients had DM at the time of diagnosis. Distant metastasis was found in 33% (30/91) of patients with DM compared with only 9.7% (17/174) of those without DM (OR: 4.5, 95% CI: 2.3-8.8, p < .0001). This difference remained significant when adjusting for other clinical variables (OR: 10.0, 95% CI: 3.9-25.7, p < .0001).'] Is diabetes mellitus associated with the presence of metastatic spread at disease presentation in hepatocellular carcinoma?