raised ALT and use of oral hypoglycaemic medication

Last reviewed 03/2018

  • hepatic impairment is a contraindication to many different medications. Of note in diabetes, is the use of glitazones in the case of hepatic impairment associated with non-alcoholic fatty liver disease
    • the first glitazone, thioglitazone, was withdrawn from use after deaths occurred secondary to hepatic failure. However now there is evidence that glitazones are an effective treatment in non-alcoholic fatty liver disease
    • the use of glitazone therapy in patients with abnormal liver function tests should only be used on specialist advice (1)


  1. Personal Communication (February 9th 2006). Aresh Anwar, Consultant Diabetologist, University Hospitals Coventry and Warwickshire.