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Current Diabetes Reports
Erschienen in: Current Diabetes Reports 11/2020

01.11.2020 | Pharmacologic Treatment of Type 2 Diabetes (HE Lebovitz and G Bahtiyar, Section Editors)

Role of Agents for the Treatment of Diabetes in the Management of Nonalcoholic Fatty Liver Disease

verfasst von: Jeffrey Budd, Kenneth Cusi

Erschienen in: Current Diabetes Reports | Ausgabe 11/2020

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Abstract

Purpose of Review

Nonalcoholic fatty liver disease (NAFLD) is an often unrecognized complication of type 2 diabetes (T2DM) associated with significant economic burden and poor long-term hepatic and extrahepatic outcomes. Our goal is to review evidence about the complex association between NAFLD and T2DM and highlight the potential for disease co-management with the available medications used for the treatment of diabetes.

Recent Findings

A milieu of metabolic factors such as insulin resistance, glucotoxicity, and lipotoxicity, as well as genetics and other factors, contribute to the pathogenesis and co-existence of NAFLD with T2DM. The presence of T2DM in patients with NAFLD increases the risk of disease progression to steatohepatitis (NASH) and advanced fibrosis, cirrhosis, and even hepatocellular carcinoma. In addition to lifestyle modification, pioglitazone and glucagon-like peptide 1 receptor agonists (GLP-1RAs) both reduce the high cardiovascular risk and improve liver histology in patients with NAFLD. Sodium-glucose cotransporter (SGLT-2) inhibitors also appear to reverse metabolic abnormalities as well as liver disease in NAFLD, but their impact on liver histology has not been fully established. Lastly, metformin, dipeptidyl dipetidase-4 (DPP-4) inhibitors, and insulin appear to have modest to no effect on modifying the natural history of NAFLD.

Summary

Early recognition of NAFLD and monitoring for NASH with advanced liver fibrosis in patients with T2DM are crucial. The presence of NASH in a patient with T2DM should call for taking advantage of antidiabetic medications with proven efficacy to improve cardiometabolic health and prevent liver disease progression.
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Metadaten
Titel
Role of Agents for the Treatment of Diabetes in the Management of Nonalcoholic Fatty Liver Disease
verfasst von
Jeffrey Budd
Kenneth Cusi
Publikationsdatum
01.11.2020
Verlag
Springer US
Erschienen in
Current Diabetes Reports / Ausgabe 11/2020
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-020-01349-1

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Auch myeloide Immunzellen lassen sich mit chimären Antigenrezeptoren gegen Tumoren ausstatten. Solche CAR-Fresszell-Therapien werden jetzt für solide Tumoren entwickelt. Künftig soll dieser Prozess nicht mehr ex vivo, sondern per mRNA im Körper der Betroffenen erfolgen.

Frühzeitige HbA1c-Kontrolle macht sich lebenslang bemerkbar

22.05.2024 Typ-2-Diabetes Nachrichten

Menschen mit Typ-2-Diabetes von Anfang an intensiv BZ-senkend zu behandeln, wirkt sich positiv auf Komplikationen und Mortalität aus – und das offenbar lebenslang, wie eine weitere Nachfolgeuntersuchung der UKPD-Studie nahelegt.

Update Innere Medizin

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