Addressing NAFLD as a Type 2 Diabetes Complication Using the Emerging Paradigms in Diagnostic and Management Techniques

Authors

  • Harpreet S. Bajaj, MD, MPH, FACE LMC Diabetes & Endocrinology, Brampton, ON

DOI:

https://doi.org/10.58931/cdet.2023.119

Abstract

Several critical epidemiological facts underscore the urgent need to address non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes (T2D):

  1. NAFLD is the most common liver disease in Canada, affecting approximately one in four Canadians;
  2. NAFLD is projected to become the number one leading indication for liver transplant by 2025;
  3. Individuals with T2D are at the greatest risk of liver disease progression in NAFLD; T2D is the main predictor of NAFLD-related liver fibrosis and mortality.

To put this into clinical perspective, consider the following fictitious case: A 45-year-old teetotaler, Caucasian woman with T2D and a body mass index (BMI) of 32 kg/m2, with no microvascular or macrovascular complications, was incidentally found to have “fatty liver” on abdominal ultrasound. ALT and AST were both within normal range. She was recommended to lose weight and control A1C. Twelve years later, she developed hematemesis and liver biopsy confirmed end-stage liver cirrhosis, with hepatocellular carcinoma. She was scheduled to undergo a liver transplant at age 59.

Despite the three established facts presented above and an abundance of cases similar to the one presented here, currently NAFLD is not being addressed during routine diabetes care as a complication of T2D.

Author Biography

Harpreet S. Bajaj, MD, MPH, FACE, LMC Diabetes & Endocrinology, Brampton, ON

Dr. Harpreet Singh Bajaj is an endocrinologist and the Medical Director of Endocrine & Metabolic Research at LMC Healthcare/Centricity Research in Canada. Dr. Bajaj completed his endocrinology fellowship at the Cleveland Clinic in Cleveland, Ohio and obtained his medical degree from the University of Delhi in India, followed by a Masters of Public Health (Epidemiology) from the State University of New York in Albany, New York. Dr. Bajaj has co-authored publications in key medical journals in the fields of diabetes prevention and management of complications, obesity, and cardiovascular risk reduction. He is the principal investigator of the Canadian Diabetes Prevention Program, a nationwide collaborative effort between LMC and Diabetes Canada which is funded by the Public Health Agency of Canada. Dr. Bajaj currently serves as the Chair of the Clinical Practice Guidelines Steering Committee for Diabetes Canada.

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Published

2023-03-20

How to Cite

Bajaj, H. S. (2023). Addressing NAFLD as a Type 2 Diabetes Complication Using the Emerging Paradigms in Diagnostic and Management Techniques. Canadian Diabetes & Endocrinology Today, 1(1), 27–30. https://doi.org/10.58931/cdet.2023.119

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Volume 1, Issue 1, March 2023

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