OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) is recognized as a common cause of chronic liver disease worldwide. Its association with type 2 diabetes mellitus (T2DM) is known to increase the risk of degenerative complications of diabetes and the likelihood of developing
severe hepatic injuries. The objective of this study was to assess the prevalence of NAFLD and to describe the characteristics of its association with T2DM. METHODS: This was a descriptive analytical study, involving patients with T2DM with no history of alcohol consumption, viral
hepatitis, hepatotoxic medications, or other chronic liver diseases. The patients underwent an investigation of NAFLD including abdominal ultrasound, non-invasive biomarkers of liver fibrosis, elastography and ultrasound-guided liver biopsy. RESULTS: We collected data from 180 patients
with a mean age of 59.3 ± 10.9 years with strong female predominance. The mean duration of diabetes progression was 9.2 ± 7.3 years. Hepatic sonography showed signs of NAFLD in 45.6% of cases. Non-invasive hepatic biomarkers indicated significant fibrosis in 18.3% of cases. Overall,
21% of patients underwent an elastography evaluation, revealing severe fibrosis or cirrhosis in 15.4% of patients. The diagnosis of NASH (Non-alcoholic steatohepatitis) was confirmed histologically in 3 patients. The overall prevalence of NAFLD was 45.6%. Patients with NAFLD had a statistically
significant incidence of obesity, metabolic syndrome, hypertension, dyslipidemia, macrovascular complications, and hypertriglyceridemia (p < 0.05). CONCLUSIONS: The combination of NAFLD and T2DM is often found in patients with obesity or metabolic syndrome. The presence of NAFLD
can be responsible for increased morbidity and important cardiovascular risks in patients with T2DM.
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Self-management for type 1 diabetes mellitus patients is a real challenge especially in a time of a spreading pandemic. “Ana wa Soukari” is a newly designed smartphone application for therapeutic education and insulin doses management. Our study evaluated the effectiveness of “Ana wa soukari” on clinical and biological outcomes of type 1 diabetes self-management. Our 3 months’ follow-up results: 62 patients were included in our study. The mean age of our patients was 15 6,41 years. Sex ratio M/F = 1,1. Mean diabetes duration was 4,9 4,3 years and 67,7% of patients had diabetes for less than 5 years. Mean HbA1c levels in Group A (with application) and Group B (without application) dropped from 8,3% 2,3 and 8,2% 2 respectively at baseline to 7,4% 1,5 and 8% 1,8 at three months’ follow-up. Change in hypoglycaemic episodes was – 1,8 2,0 (P < 0,001) for Group A and – 1,2 1,5 (P < 0,001) for Group B. DTSQs was performed in both groups at end point. Scores were significantly higher in group (A) than in group (B) with a mean score of 31,8 3,4 and 28,4 3,8 respectively (P < 0,001). Self-management smartphone apps appear to be effective on glycaemic control and should be considered as an adjuvant intervention to the standard diabetes care.
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