Fatty liver disease in diabetes mellitus

Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in type 2 diabetes mellitus (T2DM),likely reflecting the frequent occurrence of obesity and insulin resistance in T2DM. NAFLD also can occurin type 1 DM (T1DM), but must be distinguished from the more common glycogen hepatopathy as a causeof hepatomegaly and liver function abnormalities in T1DM. Weight reduction achieved by diet and exerciseis effective in preventing and treating NAFLD in obese diabetic subjects. Bariatric surgery also has beenshown to reverse NAFLD in T2DM, and recently approved weight loss medications should be evaluatedfor their impact on the development and progression of NAFLD. There is limited evidence suggestingthat specific drugs used for blood glucose control in T2DM [thiazolidinediones (TZDs), glucagon-likepeptide-1 (GLP-1) analogs, and dipeptidyl peptidase-4 (DPP-4) inhibitors] and also statins may have a rolein preventing or treating NAFLD in patients with diabetes.