Diabetes &Non Alcoholic Fatty Liver Dsease NAFLD

 

Nonalcoholic fatty liver disease (NAFLD)

 was first described in the 1980s,

 But in the 21st century, NAFLD has become

 a very common condition. 

The explanation for this relatively recent problem

 is in large part due to the recent epidemic of obesity

 and type 2 diabetes (T2DM) increasing the risk of

 NAFLD. NAFLD is a silent condition that may not become manifest until severe liver damage (fibrosis or cirrhosis) 

has occurred. Consequently, NAFLD 

and its complications often remain undiagnosed. 

Research evidence shows that NAFLD is extremely common and some estimates suggest that it occurs in up to 

70% of people with T2DM. In the last 5 years,

 it has become evident that NAFLD not only 

increases the risk of cirrhosis, primary liver cancer 

and end‐stage liver disease, but NAFLD is also an important multisystem disease 

that has major implications beyond the liver. 

NAFLD increases the risk of incident T2DM, cardiovascular disease, chronic kidney disease 

and certain extra‐hepatic cancers, and NAFLD and 

T2DM form part of a vicious spiral of worsening diseases, 

where one condition affects the other and vice versa. 

Diabetes markedly increases the risk of

 liver fibrosis and liver fibrosis is the 

most important risk factor for hepatocellular carcinoma.

 It is now possible to diagnose liver fibrosis 

with non‐invasive tools and therefore 

it is important to have clear care pathways

 for the management of NAFLD in patients with T2DM. 

This review summarises key recent research 

that was discussed as part of the Banting lecture at the annual scientific conference in 2022.

Diabet Med. 2022 Jul 20;39(10):e14912. doi: 10.1111/dme.14912

Banting memorial lecture 2022: ‘Type 2 diabetes and 

nonalcoholic fatty liver disease: Partners in crime’

Christopher D Byrne 1,✉