Novel Antidiabetic Strategies and Diabetologists' Views in Nonalcoholic Steatohepatitis

Semin Liver Dis. 2022 Feb;42(1):48-60. doi: 10.1055/s-0041-1732354. Epub 2021 Jul 21.

Abstract

Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide with high prevalence, especially in individuals with obesity and type 2 diabetes. Among individuals with type 2 diabetes, the severe insulin resistant subgroup has the greatest risk of NAFLD, likely due to dysfunctional adipose tissue mass but also genetic factors, and may progress earlier to inflammatory and profibrotic nonalcoholic steatohepatitis (NASH). NASH has been associated with increased liver-related as well as cardiovascular morbidity and mortality. International diabetes associations recommend certain screening and treatment strategies for NASH in type 2 diabetes, which, however, bear several limitations such as lack of accurate noninvasive diagnostic tools and targeted treatments. Currently, antihyperglycemic drug concepts based on glucagon-like peptide-1 receptor agonists and sodium glucose cotransporter 2 inhibitors offer metabolic as well as cardiorenal benefits and provide treatment options for both hyperglycemia and NASH in type 2 diabetes.

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Non-alcoholic Fatty Liver Disease* / complications
  • Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use

Substances

  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors