Inflammation-mediated diabetes-liver disease cross-organ crosstalk: From molecular mechanisms to precision therapeutic strategies.

The rising global prevalence of diabetes mellitus and its liver complications presents a significant public health challenge. Inflammation-driven cross-organ communication plays a central role in linking these conditions. This review explores current insights into the molecular interactions between diabetes and liver disease, focusing on the role of inflammatory mediators in disease progression and therapeutic resistance. Chronic low-grade inflammation connects insulin resistance, hepatic steatosis, and fibrosis through a network of cytokines and other signaling molecules. Key processes include oxidative stress, activation of inflammatory pathways, and extracellular vesicle-mediated signaling, which together contribute to a cycle of metabolic dysfunction and tissue damage. Emerging precision therapies targeting these inflammatory pathways offer potential for disrupting the diabetes-liver axis. These include traditional anti-inflammatory drugs, cytokine inhibitors, gene therapies, and innovative delivery systems that improve treatment specificity. The integration of artificial intelligence and systems biology helps identify patient-specific inflammatory profiles, supporting personalized treatment approaches. This review discusses the challenges and potential of these therapies, emphasizing strategies that balance inflammation modulation with metabolic stability, and outlines future directions for individualized management of diabetes-related liver disease.