New opportunities for the correction of type 2 diabetes mellitus in patients with liver diseases

Liver diseases in patients with type 2 diabetes mellitus occur with a higher frequency than in the general population.  Type 2 diabetes mellitus has a negative effect on the condition of the liver, disrupting the metabolism of proteins, amino acids, fats and other substances in hepatocytes, which leads to the development of its chronic diseases.The combination  of liver pathology and diabetes mellitus is a prognostic factor of complications  and death. Type 2 sodium-glucose cotransporter  inhibitors (dapagliflozin, empagliflozin, kanagliflozin) have a positive effect on reducing the degree of fatty hepatosis,  reducing the concentration of liver enzymes and the activity of the inflammatory process in the liver, improving the histological picture of steatosis and steatohepatitis.  The progression of changes in the liver in type 2 diabetes mellitus in the form of nalcohol fatty liver disease, combining non-alcoholic steatosis and nonalcoholic steatohepatitis, which have common  mechanisms with insulin resistance syndrome, reflects the stages of formation of liver diseases, resulting in the development of cirrhosis of the liver. The conducted studies indicate the effectiveness of type 2 sodium-glucose transporters  in patients with cirrhosis of the liver. In patients with nnon-alcoholic fatty liver disease with type 2 diabetes mellitus, when treated with inhibitors SGLT2,  there is an improvement in histopathological characteristics during liver biopsy. In addition, these patients had a decrease in body mass index, waist circumference,  and glycemic level. in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease at increased risk of liver cirrhosis, a clinically significant decrease in serum alanine aminotransferase levels was observed during the treatment  of inhibitors SGLT2.I шn patients with liver diseases, the drugs are well tolerated, safe to use and can be successfully used in patients with liver failure.

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