The American Diabetes Association (ADA) has released a new consensus report emphasizing the importance of recognizing Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) as a critical comorbidity in individuals with type 2 diabetes and prediabetes. MASLD, previously referred to as nonalcoholic fatty liver disease or NAFLD, is now understood as a progressive condition that increases the risk of cirrhosis, cardiovascular disease, and impaired quality of life.
The ADA report highlights the use of the Fibrosis-4 (FIB-4) score, a noninvasive and cost-effective screening tool calculated from common laboratory tests. Routine FIB-4 scoring is recommended for adults with type 2 diabetes, particularly those with central obesity. Further evaluation may involve transient elastography or advanced imaging.
The report also provides a clear clinical algorithm for evaluation and referral, as well as pharmacotherapy recommendations tailored to disease severity. For individuals with early-stage fibrosis, lifestyle modification and diabetes therapies such as GLP-1 receptor agonists are first-line approaches. For advanced fibrosis, resmetirom is the only currently approved treatment.
The ADA emphasizes that MASLD should be approached with the same clinical rigor as other diabetes-related complications. Recommendations include integrating automated FIB-4 scoring in electronic health records (EHRs), interdisciplinary collaboration with hepatology, and clinician education using decision tools from the report.
By recognizing MASLD as a critical comorbidity and implementing these recommendations, clinicians can improve early detection, risk stratification, and treatment strategies for individuals with type 2 diabetes.
Source: https://www.hcplive.com/view/diabetes-dialogue-american-diabetes-association-statement-on-masld