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This interactive case study, presented by Diabetes & Primary Care, takes you through the necessary considerations in managing fatty liver disease in an individual with type 2 diabetes. The scenario is not unusual and is one that, as a primary healthcare worker, you could easily be confronted with. By actively engaging with this case history, you should feel more confident and empowered to manage effectively such a problem in the future.

References

  1. Byrne CD et al (2018) Tests for diagnosing and monitoring non-alcoholic fatty liver disease in diabetes. BMJ 362: 74–7
  2. Paris R, Maurel T (2021) Natural history of NAFLD. J Clin Med 10: 1161
  3. Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15: 539–53
  4. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of the NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285: 2486–97
  5. NICE (2016) Non-alcoholic fatty liver disease (NAFLD): assessment and management (NG49). www.nice.org.uk/guidance/ng49
  6. EASL-EASD-EASO (2016) EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol 64: 1388–402
  7. Eslam M et al (2020) A new definition for metabolic dysfunction-associated fatty liver disease. An international expert consensus statement. J Hepatology 73: 202–9
  8. Wainwright P (2015) Diabetes and the liver. Diabetes & Primary Care 17: 182–5
  9. Terrana L, Mancuso A (2018) Diabetes mellitus and liver disease. AME Med J 3: 93
  10. Younossi Z et al (2019) Nonalcoholic steatohepatitis is the fastest growing cause of hepatocellular carcinoma in liver transplant candidates. Clin Gastroenterol Hepatol 17: 748–55
  11. Bhatia L et al (2012) Non-alcoholic fatty liver disease: a new and important cardiovascular risk factor? Eur Heart J 33: 1190–200
  12. Vilar-Gomez E et al (2018) Fibrosis severity as a determinant of cause-specific mortality in patients with advanced non-alcoholic fatty liver disease: A multi-national cohort study. Gastroenterology 155: 443–57
  13. Adams LA et al (2017) Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases. Gut 66: 1138–53
  14. Thoma C et al (2012) Lifestyle interventions for the treatment of non-alcoholic fatty liver disease in adults: a systematic review. J Hepatol 56: 255–66
  15. Romero-Gómez N et al (2017) Treatment of NAFLD with diet, physical activity and exercise. J Hepatol 67: 829–46
  16. Vilar-Gomez E et al (2015) Weight loss through lifestyle modification significantly reduces features of non-alcoholic steatohepatitis. Gastroenterology 149: 367–78
  17. Kenneally S et al (2017) Efficacy of dietary and physical activity intervention in non-alcoholic fatty liver disease: a systematic review. BMJ Open Gastroenterol 4: e000139
  18. Colberg SR et al (2010) Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care 33: e147–67
  19. Ryan MC et al (2013) The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease. J Hepatology 59: 138–43
  20. NHS (2021) The NHS Digital Weight Management Programme. www.england.nhs.uk/digital-weight-management
  21. Hart CL et al (2010) Effect of body mass index and alcohol consumption on liver disease: analysis of data from two prospective cohort studies. BMJ 340: c1240
  22. Nash J (2017) Non-hunger eating: How to tackle it in time-limited consultations using the Eating Blueprint approach. Journal of Diabetes Nursing 21: 100–2
  23. Eslami L et al (2013) Statins for non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. Cochrane Database Syst Rev 12: CD008625
  24. Yeoman A, Diggle J (2019) How to diagnose and manage NAFLD in diabetes. Diabetes & Primary Care 21: 5–6
  25. Angulo P et al (2007) The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology 45: 846–54
  26. 26. Sterling RK et al (2006) Development of a simple non-invasive index to predict significant fibrosis patients with HIV/HCV co-infection. Hepatology 43: 1317–25
  27. MDCalc (2021) Fibrosis-4 (FIB-4) Index for Liver Fibrosis. www.mdcalc.com/fibrosis-4-fib-4-index-liver-fibrosis
  28. nafldscore.com (2021) NAFLD fibrosis score online calculator. https://nafldscore.com/index.php
  29. Cusi K et al (2016) Long-term pioglitazone treatment for patients with nonalcoholic steatohepatitis and prediabetes or type 2 diabetes mellitus: A Randomized trial. Ann Intern Med 165: 305–15
  30. Armstrong MJ et al (2016) Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN): a multicentre, double-blind, randomised, placebo-controlled phase 2 study. Lancet 65: 369–76
  31. Cui J et al (2016) Sitagliptin vs. placebo for non-alcoholic fatty liver disease: A randomized controlled trial. J Hepatol 65: 369–76
  32. Rakoski MO et al (2010) Meta-analysis: insulin sensitizers for the treatment of non-alcoholic steatohepatitis. Aliment Pharmacol Ther 32: 1211–21
  33. Mazzotti A et al (2017) Which treatment for type 2 diabetes associated with non-alcoholic liver disease? Dig Liver Dis 49: 235–40
  34. Raj H et al (2019) SGLT-2 inhibitors in non-alcoholic fatty liver disease patients with type 2 diabetes mellitus: A systematic review. World J Diabetes 10: 114–32
  35. 35. Bower G et al (2015) Bariatric surgery and non-alcoholic fatty liver disease: A systematic review of liver biochemistry and histology. Obes Surg 25: 2280–9

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