Endocrine Abstracts

Patients with type 2 diabetes (T2DM) are at increased risk of developing metabolic-dysfunction associated steatotic liver disease (MASLD), which can progress to fibrosis, cirrhosis,and hepatocellular carcinoma. Early detection and referral are key to improving outcomes. The EASL-EASD-EASO guidelines recommend screening all T2DM patients for MASLD. The FIB-4 index is a non-invasive tool to assess liver fibrosis in T2DM patients and identify those requiring further evaluation. We are introducing routine FIB-4 assessment in our diabetes clinics and sought to evaluate the level of referral to hepatology for further assessment that this would generate. As this cohort is likely to benefit from GLP 1 receptor agonist (GLP1-RA) treatment we evaluated prevalence of their use in those at high risk. We retrospectively reviewed 689 consecutive T2DM patients attending the diabetes OPD at Tipperary University Hospital over 12-months period. Demographics, medications, BMI, HbA1c, were collected along with laboratory results to calculate FIB-4 scores. Of 576 patients included, 433 (75.17%) had advanced fibrosis excluded (Group 1), and 143 (24.83%) were classified as advanced fibrosis likely or requiring further investigation (Group 2). Mean age, BMI, weight, and HbA1c were similar between groups (66.5 years, BMI ≈31 kg/m², weight ≈90 kg, HbA1c ≈64.6 mmol/mol). GLP 1-RA use was reported in 60.1% of Group 2; treatment duration was not analysed. This review highlights the prevalence of MASLD in T2DM and those at high fibrosis risk, enabling timely hepatology referral and intervention. Integrating risk stratification into routine diabetes consultations extends care beyond glycaemic control. We plan to review progress following implementation.