Can type 2 diabetes mellitus be reversed by improving nonalcoholic fatty liver disease?

Nonalcoholic fatty liver disease( NAFLD) is associated with a 2-to 3-fold increase in the risk of developing type 2 diabetes( T2 DM) in non-diabetic patients,and therefore,the NAFLD population is considered a large population at a high risk of T2 DM. In the population diagnosed with T2 DM,the prevalence rate of NAFLD reaches as high as 60%-80%. T2 DM is considered a lifelong disease in the traditional view,but recently,more and more evidence supports that T2 DM can be reversed,which brings new light to the prevention and treatment of T2 DM. The remission of T2 DM depends on the appropriate treatment methods and timing. The liver plays a key role in glucose and lipid metabolism,and excessive fat accumulation in the liver may induce insulin resistance,increased production of hepatic glucose,and increased triglyceride export,which further leads to fat deposition in the pancreas and beta-cell injury and eventually causes the onset of T2 DM. Lifestyle intervention can reduce liver fat content and achieve the remission or reversal of diabetes,and NAFLD can be regarded as an“early warning window”for T2 DM. Therefore,the treatment regimen aiming at improving liver fat content may become a good strategy to prevent and reverse diabetes.