The complex link between non-alcoholic fatty liver disease and type 2 diabetes mellitus

Abstract

Non-alcoholic fatty liver disease (NAFLD) and type 2 dia­be­tes mellitus (T2DM) are two interrelated metabolic dis­orders that share common risk factors such as obesity, phy­si­cal inactivity, and poor dietary habits. NAFLD is considered as the hepatic manifestation of insulin re­sis­tance, which is the hallmark of T2DM. The pathological re­la­tion­ship between NAFLD and T2DM is complex and bi­di­rec­tio­nal, with both disorders contributing to the pro­gres­sion of the other. The development of T2DM increases the risk of NAFLD and, conversely, NAFLD can worsen in­su­lin resistance and lead to T2DM. Early recognition and manage­ment of both disorders are important to prevent pro­gres­sion to advanced liver disease and its associated com­pli­ca­tions in patients with NAFLD and T2DM. Lifestyle mo­di­fi­ca­tions such as weight loss, increased physical ac­tiv­­ity and a balanced diet have been shown to be effec­tive in managing both NAFLD and T2DM. Additionally, phar­ma­co­lo­gi­cal interventions such as metformin and thia­zo­li­di­ne­diones can help improve insulin sensitivity and reduce liver fat content in patients with NAFLD and T2DM.