Diabetes and non‐alcoholic fatty liver disease: a bittersweet symphony

The prevalence of non‐alcoholic fatty liver disease (NAFLD) and its more progressive form non‐alcoholic steatohepatitis (NASH)1,2 has increased markedly, both in Australia and overseas, over the past two decades, as has the prevalence of frequently associated conditions such as type 2 diabetes mellitus3 and obesity.4 Further, as the most common condition affecting the liver, NAFLD is rapidly becoming the most frequent indication for liver transplantation and a major risk factor for liver cancer. Nevertheless, few strategies to combat NAFLD or NASH have been developed in Australia or overseas.5 Only limited local data are available regarding the risk factors for progressive liver disease in people with NAFLD and the roles that frequently associated conditions play in its progression.