From this study (Nutrients. 2013 May; 5(5): 1544–1560. Non-Alcoholic Fatty Liver Disease (NAFLD) and Its Connection with Insulin Resistance, Dyslipidemia, Atherosclerosis and Coronary Heart Disease. Melania Gaggini, Mariangela Morelli, Emma Buzzigoli, Ralph A. DeFronzo, Elisabetta Bugianesi, and Amalia Gastaldelli):
NAFLD is more prevalent among obese subjects and also in patients with type 2 diabetes independently of degree of obesity. The prevalence increases to 57% in obese subjects, 70% in diabetic subjects and 90% in morbidly obese people.
Even though this is very common it goes un-diagnosed in Diabetics. The reason is the patients:
have normal liver aminotransferases and clinicians do not suspect the potential presence of NAFLD
It turns out that:
…Insulin resistance is a characteristic feature of NAFLD
many studies have highlighted the association between NAFLD and several factors of metabolic syndrome, especially abdominal obesity, insulin resistance, increased serum triglycerides and small dense LDL and low HDL
It has been shown that up to 85% of subjects with NAFLD compared to 30% in controls are insulin resistant and have abnormal glucose metabolism, i.e., prediabetes or T2DM, of which they were unaware
NAFLD is associated with features of metabolic syndrome and is more prevalent among obese subjects and patients with type 2 diabetes independent of degree of obesity. The increased risk for cardio-metabolic diseases in NAFLD is caused by different factors among which hepatic overproduction of glucose, VLDL, inflammatory factors, C-reactive protein (CRP), and coagulation factors and by the presence of insulin resistance. Large trials that investigate the incidence of CVD and related mortality in subjects with NAFLD are needed to confirm this observation.