The American Diabetes Association (ADA) now recommends universal screening for fatty liver disease in individuals with type 2 diabetes and prediabetes. The new guidance provides insights into the management of this condition and emphasizes the importance of early detection. Here is a breakdown of the key points discussed in the content:
Prevalence of Liver Disease: Up to 70% of individuals with type 2 diabetes are affected by liver disease, with non-alcoholic fatty liver disease (NAFLD) being the most common form.
Risk Factors and Complications: NAFLD can lead to cirrhosis, liver cancer, cardiovascular disease, and death, highlighting the need for proactive screening and management.
Screening Recommendations: The ADA advises using the fibrosis-4 index (FIB-4) for screening individuals with type 2 diabetes or prediabetes, even those with normal liver enzyme levels.
Treatment Approaches: Lifestyle modifications are recommended for all adults with diabetes and NAFLD, with considerations for GLP-1 agonists or pioglitazone in specific cases.
Follow-Up and Referral: The ADA update includes guidance on follow-up for patients identified with high-risk fibrosis, emphasizing the importance of timely referrals.
Medication Considerations: Pioglitazone and GLP-1 agonists are highlighted as preferred treatments for individuals with biopsy-proven NASH or clinically significant liver fibrosis.
Statin Therapy: Statins are recommended for individuals with type 2 diabetes and NAFLD to mitigate cardiovascular risk, with caution advised in cases of decompensated cirrhosis.
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by Miriam E. Tu... at www.medscape.com 06-26-2023
https://www.medscape.com/viewarticle/993715Deeper Inquiries