Medicine, Di Bartolo (Amd): “Between diabetes and liver a very dangerous liason”

“Diabetic retinopathy is one of the complications with the greatest incidence and prevalence in people with diabetes: 30% of people living with type 1 and type 2 diabetes are destined to develop a fearful complication, a complication that if not taken care of it risks leading the patient towards loss of sight. Diabetic retinopathy is the number one cause of non-traumatic blindness in the world: so you understand how extremely relevant it is. What to do, how to intervene? Surely we must intervene on the risk factors that we know well which are glycemic control, optimal glycemic control that must be sought in the person with diabetes regardless of the type of diabetes, and blood pressure control. These are the elements on which the diabetologist cannot lose attention. But diabetes-retina becomes an extremely interesting topic because today we know how people who develop early or in some way aggressively develop a disease of the retina, of the small vessels of the retina are then the people who have a greater risk of experiencing complications. cardiovascular: heart attack, stroke and death from cardiovascular disease, and this is the new connotation that emerges. When we talk about diabetes-eye we cannot forget diabetic maculopathy, which is another of the eye diseases associated with diabetes. Today it has emerged that diabetic maculopathy is not only the maculopathy that we knew, therefore the vascular-based maculopathy, but there is an inflammatory component that itself can be treated and is an element of cardiovascular disease risk. Diabetes-liver is another of the topics covered in the course of our great event, the eleventh conference of AMD, diabetes-liver is a link, a very dangerous liason: do you think that fatty liver disease affects more or less one person on three walking down the street but when we go into the world type 2 diabetes. 70% of people who have type 2 diabetes have steatotic liver disease, a disease that if it is not sought and is not somehow controlled it risks , especially in people with type 2 diabetes, to slip into the more severe forms of liver disease which are fibrosis, cirrhosis and liver cancer. In addition to this we know well how in people living with type 2 diabetes the presence of severe liver disease on steatosis, on the infarction of fat attributes to this person an increased further increased risk of undergoing a cardiovascular disease: and then again heart attack, stroke and death from cardiovascular disease. Diabetes, however, does not exhaust its link with liver disease with steatotic liver disease but there are other components of other liver diseases that we have seen to be particularly relevant in the person living with diabetes and they are viral hepatitis. In particular, hepatitis C is a form of hepatitis that in people with type 2 diabetes presents itself in a particularly subtle way: we do not yet understand what the link is, it is likely that the viral disease, hepatitis C, causes the person who undergoes this condition towards a form of diabetes that resembles type 2 diabetes but is not type 2 diabetes. However, we also know that those who live with type 2 diabetes for some conditions that characterize it, one of these is the fatty infarction of the liver is more vulnerable to an attack of the hepatitis C virus. Today, however, we have understood one fundamental thing, that these patients must be sought because if they are identified, the possibility that exists today to treat these patients is concrete with therapies specifically for hepatitis C, and we know that from a clinical benefit point of view the treatment of hepatitis in people who have diabetes at the same time leads to a better dramatic increase in the disease outcomes of glycemic control and the possibility of meeting the complications “.