Poster Presentation ESA-SRB-ANZOS 2025 in conjunction with ENSA

Optimizing screening for metabolic dysfunction-associated steatotic liver disease (MASLD) in diabetes: a clinical audit of current practices (128558)

Chong Liang 1 , Daisuke Miura 1 , Ashley Wang 2 , Clement Lo 1 2 , Michael Braude 1 2 , Chau Thien Tay 1 2
  1. Monash Health, Melbourne, VIC, Australia
  2. Monash University, Melbourne, VIC, Australia

Aims

Metabolic dysfunction-associated steatotic liver disease (MASLD) commonly co-exists in most people with type 2 diabetes mellitus (DM), with a 65.3% pooled prevalence.1 It is increasingly recognised in type 1 DM with a prevalence of 22.2%.2 Furthermore, MASLD has a bidirectional relationship with DM and its metabolic cofactors.3˒4We aim to evaluate MASLD screening practices within DM at Monash Health diabetes clinics, with sub-analysis of MASLD risk factors, treatments, and referral pathways.

Methods

We conducted a retrospective cross-sectional study of all patients with DM who attended Monash Health Chronic Diabetes Management Clinics between 1 January and 9 May 2024.

Results

There were 416 individual attendees (mean age 62±15 years, 42.5% female), of whom 55.2% had type 2 DM, 19.6% type 1 DM, and 25.3% other forms. Most patients with the relevant data had longstanding DM >10 years 73.1% (277/379), and were either obese 40.0% (68/170) or overweight 37.1% (63/170). Diabetes complications were common (77.2%), including macrovascular (36.7%) and microvascular (69.0%) disease. Approximately 75.5% of patients were on insulin therapy, 31.0% on SGLT2 inhibitors, and 24.5% used GLP-1 receptor agonists.

Less than half of patients 38.0% (158/416) had liver imaging within 5-years of clinic attendance, of whom 64.0% (101/158) had imaging evidence of MASLD. An additional 7.5% (31/416) of attendees had a documented history of MASLD but no available imaging.

Of the 132 attendees with MASLD, 35.3% (47/132) had a calculable Fibrosis-4 (Fib-4) index, and 59.6% (28/47) demonstrated intermediate-to-high fibrosis risk. In this high risk subgroup, 50% (14/28) had transient elastography evaluation within the past five years, and 61% (17/28) had liver clinic follow-up.

Conclusions

MASLD is common in patients with DM, but screening, documentation, and referral practices are suboptimal. Systematic MASLD screening protocols should be integrated into diabetes care pathways, with a focus on identifying patients with progressive liver fibrosis.

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