The prevalence of NASH among patients with type 2 diabetes (T2D) is high, putting them at a significantly higher risk for developing end-stage liver disease, HCC, and CVD. There is a vicious circle, each condition worsening the other. Patients with NAFLD have an increased risk of developing type 2 diabetes, while the latter promotes the progression of simple fatty liver to a more advanced form called nonalcoholic steatohepatitis (NASH). Increased awareness about NASH and NASH-related complications is warranted among diabetologists, especially with the prospective induction of NASH-specific therapies.
Shaheen Tomah et al. review the two-way pathophysiologic relationship between NAFLD and T2D as well as the various management options currently available.
Take home message: An interdisciplinary approach is needed for the care of patients with type 2 diabetes and NAFLD, starting with early identification through non-invasive biomarkers and imaging modalities in the diabetes clinic to lifestyle modification and NASH-specific therapy in the hepatology clinic.