Keith G. Tolman, MD; Vivian Fonseca, MD; Meng H. Tan, MD; Anthony Dalpiaz, PharmD
Acknowledgments: The authors thank Rowan Tweedale for editorial support and Judy Summerhays for secretarial support.
Potential Financial Conflicts of Interest:Employment: M.H. Tan (Eli Lilly); Consultancies: K.G. Tolman (Takeda, Eli Lilly), V. Fonseca (Eli Lilly, Takeda, GlaxoSmithKline, Pfizer, Aventis); Honoraria: K.G. Tolman (Takeda, Eli Lilly), V. Fonseca (Eli Lilly, Takeda, GlaxoSmithKline, Pfizer, Aventis); Stock ownership or options (other than mutual funds): M.H. Tan (Eli Lilly); Grants received: V. Fonseca (Eli Lilly, Takeda, GlaxoSmithKline, Pfizer, Aventis).
Requests for Single Reprints: Keith G. Tolman, MD, Department of Internal Medicine, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Tolman: Division of Gastroenterology, University of Utah, 30 N 1900 E, RM 4R118, Salt Lake City, UT 84132.
Dr. Fonseca: 1430 Tulane Avenue, SL 53, New Orleans, LA 70112.
Dr. Tan: Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285.
Dr. Dalpiaz: Department of Pharmacy, University of Utah, 30 N 1900 E, Salt Lake City, UT 84132.
Diabetes mellitus is the fifth leading cause of death in the United States; 17 million people are affected. Liver disease is one of the leading causes of death in persons with type 2 diabetes. The standardized mortality rate for death from liver disease is greater than that for cardiovascular disease. The spectrum of liver disease in type 2 diabetes ranges from nonalcoholic fatty liver disease to cirrhosis and hepatocellular carcinoma. The incidence of hepatitis C and acute liver failure is also increased. Nonalcoholic fatty liver disease is now considered part of the metabolic syndrome, and, with alcohol and hepatitis C, is the most common cause of chronic liver disease in the United States. Weight reduction and exercise are the mainstays of treatment for nonalcoholic fatty liver disease, but there are promising results with the new thiazolidinediones (pioglitazone and rosiglitazone) as well as metformin and 3-hydroxy-3-methylglutaryl coenzyme A inhibitors.
Tolman KG, Fonseca V, Tan MH, Dalpiaz A. Narrative Review: Hepatobiliary Disease in Type 2 Diabetes Mellitus. Ann Intern Med. ;141:946–956. doi: 10.7326/0003-4819-141-12-200412210-00011
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Published: Ann Intern Med. 2004;141(12):946-956.
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism.
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