Maladies hepatiques chroniques et diabete.

The presence of chronic liver diseases may drastically limit the use of anti-diabetic drugs. Chronic liver diseases increase insulin resistance, and in some risk groups promote the development of diabetes. Therefore, antidiabetic treatment should be adapted to the severity of liver disease. However, diabetes, notably when associated with obesity and dyslipidemia, participates in the development of nonalcoholic fatty liver disease and to steato-hepatitis that may progress to cirrhosis and hepatocellular carcinoma. Other relations between diabetes and chronic liver disease will be discussed in this article. Finally, the indications and limits of each anti-diabetic therapy group will be discussed according to the degree of liver damage.