Non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus

Objective. To present a contemporary perspective on the epidemiology, pathogenenesis, and management of nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM). Key points. Over the past few decades, NAFLD has become the most prevalent liver disease worldwide. Insulin resistance serves as the common pathogenetic link between NAFLD and T2DM. Currently, there are no approved treatments for NAFLD, and management primarily targets various pathogenetic aspects. The review explores the potential benefits SGLT-2 inhibitors in the treatment of NAFLD and T2DM, such as weight reduction, lowered concentrations of fatty acids, attenuation of oxidative stress, and anti-inflammatory effects. The article provides a detailed analysis of the mechanisms of action of SGLT-2 inhibitors in mice with NAFLD and patients with T2DM, including the reduction of steatosis and improvement in adipose tissue function. Studies indicate that SGLT-2 inhibitors may be effective not only for improving glycemic control but also for addressing components of the metabolic syndrome. The article also discusses potential risks associated with the use of these drugs, such as urinary tract infections and candidal vulvovaginitis. Conclusion. Considering the pivotal role of insulin resistance in NAFLD development, therapy aimed at its correction currently occupies a prominent position. Insulin sensitizers are utilized for treating T2DM, exerting their effects through insulin resistance on hepatic steatosis. © 2023, Media Sphera Publishing Group. All rights reserved.