Type 2 Diabetes Mellitus and Alcoholic Liver Disease: a literature review

Abstract

Introduction

Alcoholic liver disease (ALD) and type 2 diabetes mellitus (T2DM) are two important chronic diseases in Australia, both of which are emerging epidemics. As a result, patients presenting with both conditions may become increasingly more common. However, not much is known about how each affects the other in terms of clinical outcomes.

Methods

Evidence from studies exploring the relationship between T2DM and ALD, including those pertaining to liver function tests (LFT) and hepatocellular carcinoma (HCC), was reviewed and summarised.

Results

There are studies which show that high alcohol intake and chronic liver disease (CLD) are risk factors of developing T2DM. Conversely, having impaired glucose tolerance has been shown to promote progression of CLD. There is also some evidence of increased risk of HCC in patients with T2DM and who consume alcohol in the context of other liver disease. However, no studies that looked into how T2DM directly affects LFT results in ALD were found.

Discussion

There seems to be a bidirectional relationship between T2DM and ALD, although it is not explicitly cause-and-effect in nature. Hence, there is a need for a comprehensive management plan that utilises a multidisciplinary approach to minimise the risk of complications for patients with either or both diseases. Currently, this is not available and both diseases are treated as separate entities. Therefore, further research must be done to elucidate the relationship between the two, so that effective strategies to manage co-existing T2DM and ALD can be developed.