Diabetes complications and comorbidities

Hepatic steatosis, measured by the fatty liver index, is associated with an increased risk for mortality and cardiovascular disease among people with type 1 diabetes, research suggests.

Using an insulin pump rather than multiple daily injections may help protect people with type 1 diabetes from developing fatty liver disease, report researchers.

The SGLT1/2 inhibitor licogliflozin has reduced liver enzyme levels in people with nonalcoholic steatohepatitis in a phase 2 trial published in Nature Medicine.

Researchers report that metabolic abnormalities begin to increase at levels of liver fat commonly regarded as normal.

The publication of two SURPASS-3 substudies in The Lancet Diabetes & Endocrinology reveals significant benefits of tirzepatide on liver and abdominal fat in people with type 2 diabetes, as well as on time in target glucose range.

Physicians feel that nonalcoholic fatty liver disease is sidelined in type 2 diabetes management and should be formally incorporated into routine primary care pathways, say Australian researchers.

A genetic propensity for increased liver fat and lower pancreatic volume is associated with an increased risk for type 2 diabetes, say researchers.

Gastric bypass and sleeve gastrectomy both result in “almost complete clearance of liver fat” within a year after the intervention, show secondary outcomes of a randomized trial.

The degree of non-alcoholic fatty liver disease, estimated by fatty liver index, is significantly associated with the risk for progression to type 2 diabetes in people with prediabetes, Spanish study findings indicate.

Visceral adipose tissue is strongly indicative of the presence of non-alcoholic fatty liver in people with type 1 diabetes, but fat in other areas is not, show findings from the FinnDiane study.

Researchers have detected moderate or severe liver fibrosis in around one in six people with type 2 diabetes.

Results from the D-LIFT trial suggest a reduction in liver fat content when dulaglutide, a glucagon-like peptide-1 receptor agonist, is added to standard care treatment in people with concurrent type 2 diabetes and non-alcoholic fatty liver disease.

People with non-alcoholic fatty liver disease or non-alcoholic steatohepatitis are at particularly high risk for progression to cirrhosis or hepatocellular carcinoma if they have diabetes, say researchers.

Lonardo A, Lugari S, Ballestri S et al. Acta Diabetol 2018. doi: 10.1007/s00592-018-1266-0

Kuchay MS et al. Diabetes Care 2018: dc180165. doi: 10.2337/dc18-0165

Researchers from the DiRECT trial have reported large positive effects on liver fat and insulin secretion among people who achieved type 2 diabetes remission in response to a very-low-calorie diet.

Research shows that changes in markers of the metabolic syndrome and fatty liver disease are present more than 20 years before people receive a diagnosis of type 2 diabetes.

Nat Rev Endocrinol 2017; 14: 99–114. doi: 10.1038/nrendo.2017.173

Researchers presented the results of several studies investigating the risks associated with nonalcoholic fatty liver disease and potential treatment strategies at the EASD annual meeting in Lisbon, Portugal.

Results of a randomized trial suggest that patients with type 2 diabetes experience metabolic benefits from a hypocaloric diet regardless of whether it is low in fat or low in carbohydrate content.