Antidiabetic treatment patterns in type 2 diabetic patients with metabolic associated steatotic liver disease

Yesmine Elloumi; Mouna Elleuch; Hamdi Frikha; Khouloud Boujelben; Hadjkacem Faten; Nadia Charfi; Mouna Mnif; Mohamed Abid; Salah Dhoha Ben; Majdoub Nabila Rekik

doi:10.1530/endoabs.110.EP543

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Endocrine Abstracts (2025) 110 EP543 | DOI: 10.1530/endoabs.110.EP543

ECEESPE2025 ePoster Presentations Diabetes and Insulin (245 abstracts)

Antidiabetic treatment patterns in type 2 diabetic patients with metabolic associated steatotic liver disease

Yesmine Elloumi ¹ , Mouna Elleuch ¹ , Hamdi Frikha ¹ , Khouloud Boujelben ¹ , Hadjkacem Faten ¹ , Nadia Charfi ¹ , Mouna Mnif ¹ , Mohamed Abid ¹ , Dhoha Ben Salah ¹ & Nabila Rekik Majdoub ¹

Author affiliations

¹Hedi Chaker University Hospital, Endocrinology Department, Sfax, Tunisia

JOINT424

Background: Metabolic Associated Steatotic Liver Disease (MASLD) is increasingly recognized as a common comorbidity in patients with type 2 diabetes mellitus (T2DM), complicating their management. The presence of MASLD may influence choice and effectiveness of antidiabetic pharmacotherapy, as certain treatments may have varying impacts on both liver function and glucose control. This study aims to explore the pharmacotherapeutic profile of T2DM patients with MASLD.

Methods: A retrospective, descriptive, and analytical study was conducted on 202 T2DM patients followed at the Endocrinology Department of Hedi Chaker Hospital in Sfax, Tunisia. The patients were equally divided into two groups based on the presence or absence of MASLD.

Results: Hygienic and dietary measures without pharmacotherapy were recommended for 14.9% of patients. Nearly half of the patients (48.5%) received exclusive oral pharmacotherapy, while 21.8% were treated with insulin therapy, either as monotherapy (12.9%) or in combination with oral antidiabetic agents (8.9%). Metformin was the most frequently prescribed medication, used in 57.4% of cases, followed by sulfonylureas, prescribed in 27.7% of cases—glimepiride in 15.8%, glibenclamide in 7.9%, and gliclazide in 4%. The use of newer antidiabetic drugs was limited, with only two patients receiving SGLT2 inhibitors, specifically dapagliflozin, and no patients on empagliflozin. Incretin mimetics (DPP-4 inhibitors and GLP-1 agonists) were not prescribed. Acarbose was used in 2% of cases, and glinides in 5%. Among insulin treatments, human insulin was more commonly prescribed (17.8%) compared to insulin analogs (4%). The most frequent therapeutic combinations in this population were metformin with sulfonylureas (25.7%) and insulin with metformin (10.9%). Antidiabetic treatments were not associated with the development of MASLD for oral medications (metformin: P = 0.131, sulfonylureas: P = 0.557). However, insulin therapy was significantly associated with the absence of MASLD lesions in diabetic patients (P = 0.027).

Conclusion: Understanding the nuances of antidiabetic treatment of diabetic patients with MASLD is crucial for optimizing patient care and improving therapeutic strategies.