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Feature Article

Type 2 diabetes and fatty liver disease: a pathogenic duo with clinical implications

Kathryn H Williams, Stephen M Twigg

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Abstract

Nonalcoholic fatty liver disease (NAFLD) is common in people with type 2 diabetes and its subtypes may contribute to significant morbidity and mortality. NAFLD predicts the development of diabetes and vice versa and each condition serves as a progression factor for the other.

Key Points

  • Nonalcoholic fatty liver disease (NAFLD) magnifies insulin resistance and its presence increases the risk of type 2 diabetes.
  • Type 2 diabetes progresses NAFLD, often to nonalcoholic steatohepatitis (NASH) with fibrosis.
  • Clinical noninvasive tools that enable simple and cost-effective serial assessment of NAFLD severity are increasingly available.
  • In patients with type 2 diabetes and NAFLD the primary focus of treatment is effective weight management and exercise.
  • Medications targeting NAFLD in people with type 2 diabetes, especially to potentially prevent or reverse liver fibrosis in those with NASH, require further study.

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