Research
Hormonal
Paracetamol use in patients with T2DM and Non-Alcoholic Fatty Liver Disease (NAFLD) carries a heightened risk of hepatotoxicity due to shared metabolic pathways and reduced clearance.
If you have diabetes and take paracetamol regularly for joint pain, ask your doctor to check your liver enzymes. Your liver may process the drug differently if you have fatty liver disease, increasing the risk of damage even at standard doses.
ModerateQualifiesMEDIUM confidence
Obesity and T2DM are also often associated with NAFLD and both obesity and NAFLD are able to increase the risk and severity of hepatotoxicity of different drugs, including paracetamol... caution should be recommended when considering the use of high-dose paracetamol for the management of OA-related pain in patients with T2DM and advanced NAFLD/NASH.
Why this rating
Paper notes 'limited evidence' and 'scattered reports', calling for further clinical data.
Source
Type 2 diabetes mellitus and osteoarthritis
Nicola Veronese et al. · Seminars in Arthritis and Rheumatism · 2019
DOI 10.1016/j.semarthrit.2019.01.005
narrative_reviewCited 246×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Type 2 diabetes mellitus (T2DM) acts as an independent pathogenic factor for osteoarthritis (OA) progression and arthroplasty complications through mechanisms of oxidative stress, advanced glycation end-products (AGEs), and insulin resistance, separate from mechanical load.Good
- NSAID use in T2DM patients significantly increases the risk of Acute Kidney Injury (AKI) and cardiovascular events, particularly when combined with antihypertensives or SGLT2 inhibitors.Good
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