The impact of non-alcoholic fatty liver disease in type 2 diabetes

This study examined the metabolic effect of NASH in patients with type 2 diabetes. The authors concluded that NAFLD in patients with type 2 diabetes is associated with worse metabolic effects.

Altered metabolism occurs in patients with type 2 diabetes (T2D). These effects include a reduction in the ability of insulin to work in the body. This is accompanied by higher insulin levels to compensate. Higher levels of bad fats also occur.

T2D patients may develop non-alcoholic fatty liver disease (NAFLD). NAFLD occurs due to the presence of fat in the liver. Non-alcoholic steatohepatitis (NASH – fat in the liver along with inflammation) is the most extreme form of NAFLD. NASH is common in obese patients. T2D patients have a higher risk of developing aggressive liver disease. However the effects of NASH on metabolism are unknown. It is important to identify whether NASH may affect metabolism in T2D patients as this population of patients may benefit from earlier treatment.

This study aimed to evaluate the metabolic effect of NASH in T2D patients.

This study involved 154 participants. One group of participants did not have T2D or NAFLD. The second group had T2D but did not have NAFLD. The third group had T2D and fat in the liver. The remaining group had T2D with NASH. The levels of fats in the liver measured in participants.

The oral glucose tolerance test was performed for each participant to measure how quickly blood glucose levels were reduced after ingesting glucose.

T2D patients with NASH had higher levels of insulin in the blood, a reduced ability of insulin to work and higher levels of fats in the blood.

The fat tissue in T2D patients with NASH, which normally takes up glucose in response to insulin, was less responsive to insulin. The ability of the liver to respond to insulin was also impaired in T2D patients with NASH compared to participants in the other groups. The ability of insulin to lower fat levels in the blood was also reduced.

This study concluded that the presence of NAFLD in T2D patients was associated with worse metabolic effects compared to patients without NAFLD.