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Review
. 2025 Nov 6:100528.
doi: 10.1016/j.clinme.2025.100528. Online ahead of print.

Diabetes and the Liver

E Dadey  1 , T Y Lim  2 , J Makaronidis  3
Affiliations
Free article
Review

Diabetes and the Liver

E Dadey et al. Clin Med (Lond). .
Free article

Abstract

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 mean 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.

Keywords: MASLD; diabetes; liver; metabolic; obesity.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: J Makaronidis reports financial support was provided by National Institute for Health and Care Research (NIHR). J Makaronidis reports financial support was provided by Society for Endocrinology. J Makaronidis reports institutional financial support was provided by Novo Nordisk. J Makaronidis reports institutional financial support was provided by Rhythm Pharmaceuticals Inc. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. E Dadey and TY Lim declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported on this paper.

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