Diabetes mellitus is a chronic metabolic disorder marked by hyperglycemia and systemic complications, including hepatic dysfunction, significantly contributing to disease progression and morbidity. This article reviews recent advances in gene-based therapeutic strategies targeting hepatic complications in diabetes, offering a promising approach for precision medicine by addressing underlying molecular mechanisms. Traditional treatments for hepatic complications in diabetes often manage symptoms rather than molecular causes, showing limited efficacy. Gene-based therapies are poised to correct dysfunctional pathways and restore hepatic function. Fundamental gene therapy approaches include gene silencing via small interfering RNAs (siRNAs) to target hepatic glucose production, lipid metabolism, and inflammation. Viral vectors can restore insulin sensitivity and reduce oxidative stress in diabetic livers. Genome editing, especially CRISPR-Cas9, allows the precise modification of disease-associated genes, offering immense potential for hepatic complication treatment. Strategies using CRISPR-Cas9 to enhance insulin receptor expression and modulate aberrant lipid regulatory genes are explored. Safety challenges in gene-based therapies, such as off-target effects and immune responses, are discussed. Advances in nanoparticle-based delivery systems and targeted gene editing techniques offer solutions to enhance specificity and minimize adverse effects. In conclusion, gene-based therapeutic approaches are a transformative direction in managing hepatic complications in diabetes. Further research is needed to optimize efficacy, safety, and long-term outcomes. Nevertheless, these innovative strategies promise to improve the lives of individuals with diabetes by addressing hepatic dysfunction's genetic root causes.

糖尿病是一种慢性代谢性疾病，以高血糖和全身并发症（包括肝功能障碍）为特征，显着促进疾病进展和发病。本文回顾了针对糖尿病肝脏并发症的基于基因的治疗策略的最新进展，通过解决潜在的分子机制为精准医疗提供了一种有前景的方法。糖尿病肝脏并发症的传统治疗方法通常是针对症状而非分子原因，因此疗效有限。基于基因的疗法有望纠正功能失调的途径并恢复肝功能。基本的基因治疗方法包括通过小干扰 RNA (siRNA) 进行基因沉默，以靶向肝脏葡萄糖生成、脂质代谢和炎症。病毒载体可以恢复胰岛素敏感性并减少糖尿病肝脏的氧化应激。基因组编辑，尤其是 CRISPR-Cas9，可以精确修改疾病相关基因，为肝脏并发症的治疗提供巨大潜力。探索使用 CRISPR-Cas9 增强胰岛素受体表达和调节异常脂质调节基因的策略。讨论了基于基因的疗法的安全挑战，例如脱靶效应和免疫反应。基于纳米颗粒的递送系统和靶向基因编辑技术的进步提供了增强特异性并最大限度地减少不利影响的解决方案。总之，基于基因的治疗方法是治疗糖尿病肝脏并发症的变革方向。需要进一步研究来优化疗效、安全性和长期结果。尽管如此，这些创新策略有望通过解决肝功能障碍的遗传根源来改善糖尿病患者的生活。