Diabetes mellitus and fatty liver diseases

Nonalcoholic fatty liver disease (NAFLD) is a common, but often underestimated comorbidity of diabetes mellitus. It may not only be a consequence of diabetes, but may also precede it. Due to cardiovascular and hepatic complications and malignancies, NAFLD is associated with increased morbidity and mortality. Patients from high-risk groups should therefore be screened for NAFLD. In addition to evaluation of steatosis using ultrasound imaging, the presence of liver fibrosis using risk scores is recommended. As advanced NAFLD is associated with an increased risk of hepatocellular carcinoma (HCC), screening should be considered. In addition to the general management of obesity and insulin resistance, selection of an antidiabetic drug, use of statins and inhibitors of the renin-angiotensin system, and acetylsalicylic acid (aspirin) may be beneficial.