Implementation of a liver health check in people with type 2 diabetes
2024
Abeysekera, K. W. M. | Valenti, L. | Younossi, Z. | Dillon, J. F. | Allen, A. M. | Nourredin, M. | Rinella, M. E. | Tacke, F. | Francque, S. | Gines, P. | Thiele, M. | Newsome, P. N. | Guha, I. N. | Eslam, M. | Schattenberg, J. M. | Alqahtani, S. A. | Arrese, M. | Berzigotti, A. | Holleboom, A. G. | Caussy, C. | Cusi, K. | Roden, M. | Hagström, H. | Wong, V. W. | Mallet, V. | Castera, L. | Lazarus, J. V. | Tsochatzis, E. A. | Department of Medicine III ; RWTH Aachen University = Rheinisch-Westfälische Technische Hochschule Aachen (RWTH Aachen) | Antwerp University Hospital [Edegem] (UZA) | University of Antwerp (UA) | Hospital Clínic de Barcelona | Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas ; Partenaires INRAE | Institut d'Investigacions Biomèdiques August Pi i Sunyer | University Medical Center of the Johannes Gutenberg-University Mainz | Pontificia Universidad Católica de Chile (UC) | Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN) ; Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) | Centre d'Enseignement et de Recherche en Environnement Atmosphérique (CEREA) ; École nationale des ponts et chaussées (ENPC)-EDF R&D (EDF R&D) ; EDF (EDF)-EDF (EDF) | Génétique du cancer et des maladies neuropsychiatriques (GMFC) ; Université de Rouen Normandie (UNIROUEN) ; Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM) | Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC) ; Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)
International audience
Afficher plus [+] Moins [-]anglais. As morbidity and mortality related to potentially preventable liver diseases are on the rise globally, early detection of liver fibrosis offers a window of opportunity to prevent disease progression. Early detection of non-alcoholic fatty liver disease allows for initiation and reinforcement of guidance on bodyweight management, risk stratification for advanced liver fibrosis, and treatment optimisation of diabetes and other metabolic complications. Identification of alcohol-related liver disease provides the opportunity to support patients with detoxification and abstinence programmes. In all patient groups, identification of cirrhosis ensures that patients are enrolled in surveillance programmes for hepatocellular carcinoma and portal hypertension. When considering early detection strategies, success can be achieved from applying ad-hoc screening for liver fibrosis in established frameworks of care. Patients with type 2 diabetes are an important group to consider case findings of advanced liver fibrosis and cirrhosis, as up to 19% have advanced fibrosis (which is ten times higher than the general population) and almost 70% have non-alcoholic fatty liver disease. Additionally, patients with type 2 diabetes with alcohol use disorders have the highest proportion of liver-related morbidity of people with type 2 diabetes generally. Patients with type 2 diabetes receive an annual diabetes review as part of their routine clinical care, in which the health of many organs are considered. Yet, liver health is seldom included in this review. This Viewpoint argues that augmenting the existing risk stratification strategy with an additional liver health check provides the opportunity to detect advanced liver fibrosis, thereby opening a window for early interventions to prevent end-stage liver disease and its complications, including hepatocellular carcinoma.
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