[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-415676-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-415676-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","diabetes-and-the-liver-review","Diabetes and the liver - review","","Type 2 diabetes mellitus (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD) are closely linked through shared mechanisms involving insulin resistance, chronic inflammation, and excess lipid deposition. MASLD has become a major cause of cirrhosis and hepatocellular carcinoma, with high prevalence among people with T2D. This review outlines how MASLD and T2D influence each other bidirectionally, and presents diagnostic and management approaches. It highlights lifestyle intervention, cardiometabolic risk optimization, multidisciplinary care, and evidence for antidiabetic therapies including SGLT-2 inhibitors and GLP-1 receptor agonists, emphasizing early MASLD identification to reduce progression risk.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/diabetes-and-the-liver-review/415676/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/diabetes-and-the-liver-review/415676.png","ImageObject",300,407,{"name":42,"@type":43},"นรินทร์","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-06","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",14,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the relationship between T2D and MASLD?","Question",{"text":63,"@type":64},"T2D and MASLD are linked bidirectionally. Insulin resistance and lipid accumulation promote MASLD, while steatotic liver disease increases hyperglycaemia and raises the risk of developing T2D.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How is MASLD defined in the article?",{"text":68,"@type":64},"MASLD is characterized by excess triglyceride storage in the liver together with at least one cardiometabolic risk factor.",{"name":70,"@type":61,"acceptedAnswer":71},"What management strategies are discussed for T2D in the context of MASLD?",{"text":72,"@type":64},"Management includes lifestyle intervention, optimization of cardiometabolic risk factors, and multidisciplinary team involvement. The article also evaluates antidiabetic medications such as SGLT-2 inhibitors and GLP-1 receptor agonists.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},415676,1790673563,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":102,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},2336475104957,"https://ap-avatar.wpscdn.com/avatar/22000c4c6bd8a5076e1?x-image-process=image/resize,m_fixed,w_180,h_180&k=1787554080175789136","Clinical Medicine 26 (2026) 100528  \nContents lists available at ScienceDirect  \nClinical Medicine  \njournal homepage: [https://www.sciencedirect.com/journal/clinical-medicine](https://www.sciencedirect.com/journal/clinical-medicine)  \n| CME: Diabetes |  |  |\n| --- | --- | --- |\n| Diabetes and the liver ✩\u003Cbr>Ebo Dadeya,∗, Tiong Yeng Limb, Janine Makaronidisa,c,d,\\# |  | |\n| a Department of Diabetes and Metabolism, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom b Department of Hepatology, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom\u003Cbr>c Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London, UK d National Institute of Health Research, UCLH Biomedical Research Centre, London, UK |  |  |\n| a r t i c l e i n f o\u003Cbr>Keywords: MASLD Diabetes Metabolic Obesity Liver | a b s t r a c t |  |\n|  | Type 2 diabetes mellitus (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD), formerly termed non-alcoholic fatty liver disease (NAFLD), are increasingly prevalent conditions that are closely associated. The shared pathophysiology of insulin resistance, chronic inflammation and increased lipid deposition means that there is a bidirectional relationship between the two conditions. MASLD is now a leading cause of cirrhosis and hepatocellular carcinoma (HCC) and has a high prevalence in patients with T2D. This review explores the synergy between MASLD and T2D, while also outlining the diagnostic approach and management of T2D in the context of MASLD. Management involves lifestyle intervention, optimisation of cardiometabolic risk factors and multidisciplinary team involvement. We evaluate the use of antidiabetic medication such as SGLT-2 inhibitors and GLP-1 receptor agonists. Early identification of MASLD can help guide treatment and reduce the risk of progression to liver cirrhosis in high-risk patients. |  |\n\nIntroduction  \nIn the UK, an estimated 5.8 million people live with diabetes mellitus (DM); 90% have type 2 diabetes (T2D).1 The co-existence with liver disease is a well-recognised association that is not always prioritised in clinical practice. The formerly termed non-alcoholic fatty liver disease (NAFLD) is now called metabolic dysfunction-associated steatotic liver disease (MASLD).  \nAs defined by the European Association for the Study of the Liver (EASL),2 MASLD is the presence of excess triglyceride storage in the liver with at least one cardiometabolic risk factor. MASLD and T2D are closely associated, both raising the risk of cardiovascular disease.2 Thereis a bidirectional relationship between DM and liver disease: type 1 diabetes (T1D) can lead to excess hepatic fat while on insulin therapy;3 T2D increases hepatic lipid production and the risk of atherosclerotic disease; similarly, steatotic liver disease increases hyperglycaemia,3 increasing the risk of developing T2D.4 This review explores how T2D is a cause and consequence of liver dysfunction.  \nLiver disease and diabetes  \nThe association with liver disease and diabetes primarily concerns T2D and MASLD. T2D has the hallmark of insulin resistance (IR) and it is acquired via genetic and environmental factors, resulting in hyperglycaemia, subsequent lipogenesis and increased fatty acid deposition.3 Fig. 1 describes the relationship between T2D pathophysiology, lipid metabolism and the liver.  \nMASLD  \nMASLD is a spectrum of conditions that includes steatosis (MASL), steatohepatitis (MASH) and liver fibrosis2 , 4 (Fig. 2).  \nIn T2D there is an increased hepatic uptake of FFA and de novo liponeogenesis5 (Fig. 1). Adipokines such as leptin and tumour necrosis factor-alpha (TNF-a) are produced in excess and promote inflammation, cellular necrosis and ultimately fibrosis.  \n✩ This article has an accompanying continuing medical education (CME) activity. Completion of this CME activity enables RCP members to earn two external CPD credits. The CME questions are available a","cbCaii4EPdCqVR3a","https://ap.wps.com/l/cbCaii4EPdCqVR3a","pdf",963305,"English","# Introduction\n# Liver disease and diabetes\n# MASLD\n# Clinical implications and management","[{\"question\":\"What is the relationship between T2D and MASLD?\",\"answer\":\"T2D and MASLD are linked bidirectionally. Insulin resistance and lipid accumulation promote MASLD, while steatotic liver disease increases hyperglycaemia and raises the risk of developing T2D.\"},{\"question\":\"How is MASLD defined in the article?\",\"answer\":\"MASLD is characterized by excess triglyceride storage in the liver together with at least one cardiometabolic risk factor.\"},{\"question\":\"What management strategies are discussed for T2D in the context of MASLD?\",\"answer\":\"Management includes lifestyle intervention, optimization of cardiometabolic risk factors, and multidisciplinary team involvement. The article also evaluates antidiabetic medications such as SGLT-2 inhibitors and GLP-1 receptor agonists.\"}]","Diabetes and the liver - review | PDF",1790602394,15]