Globally, the number of patients with coexisting non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2D) is increasing. As these patients display a deleterious metabolic profile (e.g. hypertriglyceridemia), and increased mortality rates relative to those with NAFLD or T2D in isolation, effective treatment strategies are urgently required.

At present, there exists no approved pharmacological treatment for NAFLD, and as such lifestyle interventions represent the recommended management strategy.

On the basis of the available evidence, it appears that both increasing physical activity levels and adopting a hypocaloric diet reduce intrahepatic triacylglycerol (IHTAG) content and improve glycaemic control/insulin sensitivity in patients with both NAFLD and T2D.

Future research is required to establish the cost-effectiveness of lifestyle interventions and the feasibility of delivering such interventions within a clinical setting.