The Nexus of NASH and T2DM: The Emerging Role of the Diabetologist

NAFLD is a spectrum of potentially progressive liver disorders, ranging from simple hepatic steatosis to such severe forms as NASH, fibrosis, and cirrhosis.1 The prevalence rates of both NAFLD and NASH have been steadily trending upwards for years, mirroring the rapid and well-documented expansions of patient populations with obesity and/or T2DM.2-4 Thus, in the coming decade, burdens associated with this under-recognized epidemic are likely to increase exponentially for patients, clinicians, and health care systems.2-4 Of note, NAFLD is extremely common in individuals with T2DM, and the presence of both disorders significantly increases the likelihood that steatohepatitis and cirrhosis will develop compared with NAFLD cohorts without persistent hyperglycemia.4,5 Thus, endocrinologists and other clinicians with a focus on diabetes management are essential to accelerating the identification of patients with NAFLD. Importantly, however, appropriate diagnostic and management approaches for patients with T2DM who have advanced fibrosis markedly differ from those for patients who have received an NAFLD diagnosis, and best-practice strategies are quickly evolving.5 During this Interactive Exchange™ program, expert faculty will highlight epidemiologic and pathophysiologic relationships between NASH and T2DM, review recommendations for disease diagnosis and patient referral, and discuss current management options and the latest evidence for emerging NASH therapies.

References:
1. Haas JT, et al. Pathophysiology and mechanisms of nonalcoholic fatty liver disease. Annu Rev Physiol. 2016;78:181-205.

2. Hassan K, et al. Nonalcoholic fatty liver disease: a comprehensive review of a growing epidemic. World J Gastroenterol. 2014;20(34):12082-12101.

3. Estes C, et al. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology. 2018;67(1):123-133.

4. Calzadilla Bertot L, Adams LA. The natural course of non-alcoholic fatty liver disease. Int J Mol Sci. 2016;17(5):774.

5. Singh A, et al. Prevalence of non-alcoholic fatty liver disease and advanced fibrosis in type-2 diabetic patients via non-invasive methods. J Hepatol. 2017;66(suppl 1):S150.