Diabetic patients have more elevated liver enzymes(Non Alcoholic Fatty Liver Disease –NAFLD) than non diabetic individuals. Prevalence of NAFLD is increasing due to childhood obesity.

Current therapies are based on many different pathways that lead to the development of NAFLD. There is currently no US Food and Drug Administration-(FDA) approved medical therapy for NAFLD. Therapeutic modalities are currently aimed at: (1) treatment of the metabolic conditions of diabetes and hyperlipidemia; (2) improving insulin sensitivity with medications, exercise and weight loss; (3) hepatoprotective medications to buffer oxidative stress, limit inflammatory cytokines and reduce fibrosis.

Non-alcoholic steatohepatitis (NASH) is a more advanced form of NAFLD in which there is inflammation in and around the fatty liver cells.

Complete regression of NASH(Non-alcoholic Steatohepatitis ) is not possible through current therapies, but weight loss (through diet and exercise or bariatric surgery or through medications) remains the corner stones of therapy. A goal of 7-10% body weight loss should be targeted over 6-12 month.