Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) have complex and bidirectional relations. 

NAFLD increases the risk of incident diabetes. It is greatly prevalent in T2DM patients and T2DM is a triggering factor for NAFLD. 

Thus promptly diagnosing and treating T2DM in subjects with NAFLD, as well as NAFLD in those with T2DM is crucial.

A study explored PubMed/MEDLINE for studies explaining the simultaneous occurrence of NAFLD and T2DM, and their epidemiological, diagnostic and therapeutic aspects. 

The following observations were noted-

• People should be educated about NAFLD as liver disease and an end-organ complication of T2DM. 
• Simple non-invasive tools should be encouraged in patients with potentially severe liver disease. 
• NAFLD and T2DM can be managed effectively by lifestyle optimization to achieve significant weight loss. 
• Currently, there is a lack of approved drugs for treating NAFLD in patients with T2DM, however, Vitamin E and pioglitazone might be used in selected patients. 
• Approved diabetic medications have proven effective in treating NAFLD.
• Several liver-specific drugs are being evaluated for their use in NAFLD.
• A combination approach seems to be the future of NAFLD therapeutics.

Source: Expert Rev Gastroenterol Hepatol. 2019 Sep;13(9):849-866. doi: 10.1080/17474124.2019.1649981. Epub 2019 Aug 8. PMID: 31353974