Diabetes is one of the world’s fastest-growing chronic conditions, affecting over 500 million people globally. While most discussions around diabetes focus on blood sugar control, heart health, and kidney disease, there’s another serious complication that’s often left in the shadows –> liver disease.

More specifically, people with diabetes, both type 1 and type 2, are at high risk of developing Metabolically Dysfunctional-Associated Steatotic Liver Disease (MASLD), previously known as NAFLD. This condition is characterized by excess fat buildup in the liver, and it can progress silently to advanced fibrosis, cirrhosis, and even liver cancer.

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What the Research Shows?

Recent studies have revealed alarming connections between diabetes and liver disease:

• MASLD prevalence is high in people with type 2 diabetes, even in primary care settings.

• Advanced fibrosis increases the risk of liver cancer by 3x and other cancers by 4x.

• People with type 1 diabetes are not immune, especially if they have metabolic risk factors such as obesity, hypertension, or dyslipidemia.

• While MASLD prevalence in type 2 diabetes patients has seen a slight decrease in some populations, rates of advanced fibrosis are still climbing.

This means fewer people are being diagnosed with early-stage disease, but more are progressing to dangerous late-stage conditions.

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Why Diabetes Patients Are at Higher Risk?

Several factors make diabetes patients more vulnerable to liver damage:

• Insulin resistance leads to the accumulation of fat in the liver.

• Chronic inflammation accelerates fibrosis progression.

• Shared risk factors like obesity, high cholesterol, and hypertension worsen outcomes.

The most concerning part? MASLD is often asymptomatic in its early stages, meaning patients can have significant liver damage without any warning signs.

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Case for Early Screening

For patients with diabetes, liver screening should be as routine as eye exams or kidney function tests. Early detection means:

• Identifying steatosis before it turns into fibrosis.

• Monitoring inflammation and disease progression.

• Implementing lifestyle or medication interventions at the right time.

Non-invasive tools like LIVERFASt™ and LIVERSTAT from Fibronostics make this possible. These blood-based tests evaluate fibrosis, activity, and steatosis without the need for invasive liver biopsies. They deliver fast, reliable results and can be repeated over time to track treatment response.

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Final Note

Diabetes and liver disease are intersecting epidemics, and ignoring the link could be costly. By integrating non-invasive liver testing into diabetes management, we can shift from reactive treatment to proactive prevention.

In the fight against diabetes complications, let’s not overlook the liver. It’s time to bring liver health into the conversation and routine care.