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Clinicians should screen adults with type 2 diabetes or prediabetes for nonalcoholic fatty liver disease (NAFLD), according to a guideline update to the American Diabetes Association’s Standards of Care in Diabetes — 2023. 

The recommendation is particularly relevant for patients with obesity or cardiometabolic risk factors and those with established cardiovascular disease, the update’s authors wrote. Early diagnosis will help to ensure the optimal outcomes, the ADA said. 

The changes to the ADA standards reflect an increased recognition of NAFLD as a major complication of diabetes, along with other liver problems, the update’s authors said. Up to 70% of people with type 2 diabetes are affected by liver disease, of which NAFLD is the most common type. It can lead to cirrhosis and liver cancer, and is also linked to an higher risk of cardiovascular disease and death.

Early detection and management of NAFLD in people with diabetes will help to reduce their odds of developing other serious complications, the authors said in a statement.

“Diabetes and liver disease are closely linked, and it is essential that healthcare professionals have the most current information to effectively detect and manage this disease,” said Nuha ElSayed, MD MM Sc, who oversees the ADA standards of care guidelines.

The guideline update also covers treatment and management recommendations, including lifestyle management and medications.

The Standards of Care in Diabetes — 2023 is accessible online.

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