Connection Between Non-Alcoholic Fatty Liver Disease and Diabetes Mellitus

Nonalcoholic fatty liver disease (NAFLD) is the commonest liver condition in the world, accounting for 20-30% of the adult population, and encompasses a spectrum of liver disorders characterized by fat accumulation within the liver, associated or not with varying degrees of hepatic inflammation and liver fibrosis through to cirrhosis. The prevalence of NAFLD increases significantly in the presence of obesity (60-80%) and type 2 diabetes (60%). NAFLD is associated with metabolic disorders (type 2 diabetes, obesity and hyperlipidemia) grouped together as the metabolic syndrome (MetS). It is now regarded as the hepatic manifestation of this syndrome and is closely linked to insulin resistance (IR).The presence of NAFLD predicts the development of type 2 diabetes independent of established risk factors. NAFLD patients should therefore be screened for diabetes, including by the Oral Glucose Tolerance Test (OGTT) if there any abnormalities of fasting blood glucose (FBG) and given appropriate lifestyle advice. Early diagnosis with the institution of lifestyle measures could help prevent or retard the onset of these metabolic disorders. Type 2 diabetes causes more severe non-alcoholic steatohepatitis (NASH), and patients with diabetes have an increased risk for cirrhosis and the development of hepatocellular carcinoma (HCC)