Patient Management in Non-Alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus

Aim. A current overview of non-pharmacological and drug-based approaches to non-alcoholic fatty liver disease (NAFLD) combined with type 2 diabetes mellitus (T2D). Key points. NAFLD is associated an increased cardiovascular risk (due association “metabolic syndrome”) the risks cirrhosis hepatocellular carcinoma. Macro- microvascular complications in T2D comorbidity entail a higher overall mortality. conjunction lifestyle change rational medication strategies reach target levels glycosylated haemoglobin, low-density lipoprotein cholesterol, systolic diastolic blood pressure key management such patients. body weight loss by 5–7 % or more (through caloric restriction bariatric surgery) promotes marked reduction fat even reversal steatohepatitis. Metered exercise exerts this effect at insignificant loss. Minimising alcohol consumption smoking critical. hepatotropic drug therapy most essential moderate fibrotic NAFLD. It includes antidiabetic agents (metformin, thiazolidinediones, glucagon-like peptide-1 receptor agonists, sodium-glucose co-transporter-2 inhibitors), bile acid preparations (e.g., 24-nor-ursodeoxycholic acid), farnesoid X agonists (obeticholic acid, tropifexor), statins, acetylsalicylic acid. Combinations are superior individual-drug schemes. Conclusion. The NAFLD-T2D requires close inter-specialty involvement from hepatology, gastroenterology, endocrinology cardiology. This interdisciplinary problem can be tackled through persuasive recommendations choosing proved hepatoprotective efficacy.