10 | Himalaya Livline | Vol 6 | No. 5 | Sep–Dec 2023 expert comments Liv.52® (DROPS, SYRUP, TABLET, DS SYRUP, DS TABLET) Unparalleled in liver care Dosage Acute viral hepatitis Drops: 5 to 10 Drops TID (infants); 10 to 20 Drops TID (children) Syrup: 5 mL TID (children); 10 mL TID (adults) Tablet: 1 Tablet TID (children); 2 Tablets TID (adults) Syrup: 5 mL BID/TID (children); 10 mL BID/TID (adults) Tablet: 1 Tablet TID (children); 2 Tablets TID (adults) Drug-induced hepatitis DS Syrup/DS Tablet: 1 to 2 Teaspoonsful/Tablets BID with anti-TB/ Alcohol-induced liver damage Syrup: 10 to 15 mL TID Tablet: 2 to 3 Tablets TID Anorexia and suboptimal growth Drops: 5 to 10 Drops TID (infants); 10 to 20 Drops TID (children) Liv.52 is a hepatospecific formulation, designed for the treatment and management of liver disorders. An InterviewWith Dr Smita Datta Doctor, does type 2 diabetes mellitus (T2DM) increase the risk of developing nonalcoholic fatty liver disease (NAFLD)? Yes, T2DM is one of the important risk factors for the development of NAFLD. T2DM is the most common metabolic disorder that contributes to the development of various liver abnormalities such as liver fibrosis, cirrhosis, NAFLD, nonalcoholic steatohepatitis (NASH), hepatocellular carcinoma, and chronic viral hepatitis. T2DM is commonly associated with insulin resistance (IR). IR promotes excess accumulation of free fatty acids (FFAs) in the peripheral adipose tissue of the liver, which results in the development of fatty liver and consequently, NAFLD and fibrosis. How are NAFLD and T2DM interconnected? NAFLD and T2DM are related bidirectionally. In patients with T2DM, the excess glucose stored in the liver undergoes glycolysis and is eventually converted into fatty acids and triglycerides. Furthermore, IR causes impairment in the secretion of very low-density lipoprotein, which in turn leads to hepatic fat accumulation and results in the development and progression of NAFLD. On the other hand, in patients with NAFLD, excess fat deposition in the liver makes the body more resistant to insulin and strains the pancreatic β cells, resulting in the development of T2DM. The coexistence of NAFLD and T2DM can increase the risk of development of NASH, liver fibrosis, and cirrhosis. What are the hepatic complications generally seen in patients with T2DM? Patients with T2DM are likely to have NAFLD and are at a high risk of developing other hepatic complications such as NASH, cirrhosis, hepatocellular carcinoma, and portal hypertension. What metabolic alterations pertaining to fatty acid metabolism occur in patients with T2DM? Many adverse metabolic alterations occur with respect to fatty acid metabolism in patients with T2DM. In these patients, severe atherogenic dyslipidemia with hypertriglyceridemia, a low level of high-density lipoprotein cholesterol, and the presence of smaller and denser low-density
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