Dr Muhammad Shakeel Khan, Dr Fawad Ullah, Dr Azmatullah
Recently, the complicated relationship between liver and diabetes has gained immense importance. The chief pathogenic determinant in diabetes and fatty liver is insulin resistance. Hypothalamus, intestinal microbiome, inflammation, and white adipose tissues also play a significant role in defining this link of the liver and diabetes. The initiator of systemic insulin resistance is the hepatocyte insulin resistance that also depicts the danger of fatty acids. The body’s stress response in the form of apoptosis, lipotoxicity, endoplasmic reticular stress, and lipoautophagy are all linked with the above-mentioned relationship. Various biochemical pathways and risk factors support type 2 diabetes in the development of progressive liver disease, like cirrhosis, liver cancer, and non-alcoholic steatohepatitis. This circular pathway which leads to liver disease towards type 2 diabetes, and type 2 diabetes to liver disease is a vicious cycle. After searching multiple sources and clinical examination, this review paper is compiled with critical analysis, which throws significant light upon the development of type 2 diabetes in patients with non-alcoholic fatty liver disease. Moreover, the detrimental effects of type 2 diabetes in the liver are also discussed.