Tabriz University of Medical Sciences Advanced Pharmaceutical Bulletin 2228-5881 15 4 2025 11 15 Diabetes and NAFLD: A Synergistic Threat to Metabolic Health 766 778 10.34172/apb.025.44094 EN Shilpa Chaudhary https://orcid.org/0009-0003-0911-0601 Keerti Manocha Praveen Malik Monica Aggarwal Rekha Rao Minakshi Garg https://orcid.org/0000-0002-5065-0832 REVIEW 10.34172/apb.025.44094 2024 12 30 2025 09 25 Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2Dm) are increasingly recognized as interrelated metabolic disorders, each contributing to the other’s progression. NAFLD, a leading cause of chronic liver disease globally, is often underdiagnosed due to its asymptomatic nature. The startlingly high frequency of NAFLD, especially in those with T2Dm, emphasizes the need of thorough screening in high-risk groups. In the setting of T2Dm, the pathophysiology of NAFLD comprises intricate metabolic pathways that exacerbate the disease’s progression. These pathways include insulin resistance, lipotoxicity, and chronic inflammation. Early diagnosis and timely intervention are crucial to prevent the advancement of NAFLD to more severe stages, such as nonalcoholic steatohepatitis (NASH) and cirrhosis. Current guidelines advocate for routine NAFLD screening in patients with T2Dm, emphasizing the importance of early detection. Therapeutic approaches have evolved that are pivotal in managing these intertwined conditions. Each of these treatments offers unique benefits, from improving glycemic control to mitigating liver fat accumulation and reducing cardiovascular risks. This review highlights the pathophysiological linkages, clinical implications, and therapeutic advancements in managing these conditions. By exploring global prevalence, emerging diagnostic tools, and novel therapies, we propose an integrative framework for improved patient outcomes.