Symposium 9: Diabetes management of the patient with fatty liver thinking about the pandemic

Abstract

Symposium 9: Hepatic involvement in diabetes: beyond the liver

Diabetes management of the patient with fatty liver thinking about the pandemic

In the last years, we have witnessed great advances in pharmacological treatments for patients with type 2 diabetes (T2D). Due to a higher availability of therapeutic options, choosing a pharmacological treatment requires an exhaustive analysis of the clinical characteristics of each patient. The presences of cardiovascular diseases, heart failure, chronic kidney disease and hypoglycemia risk are the most important considerations when choosing the best therapeutic option for the T2D patient. Unfortunately, the presence of non-alcoholic fatty liver (NAFLD) is a complication of T2D that is frequently overlooked by the healthcare team and its presence could lead to therapeutic implications.

Patients with T2D not only show a higher risk of developing NAFLDs, but they also show a higher progression to severe forms of the disease, including advanced liver fibrosis, cirrhosis and hepatocellular carcinoma. Epidemiologic studies estimate that around a 55% of the patients with T2D have NAFLD, and, from that figure, a 70% have the form with inflammation and necrosis, known as non-alcoholic steatohepatitis (NASH). As a consequence of the increase of obesity and T2D prevalence in the world, NASH has become the second most frequent cause of liver transplant, and will probably soon consolidate as the first cause. We are facing a pandemic; a real problem for public health.