Type 2 diabetes (T2D) and liver disease are closely linked, with both conditions sharing common metabolic drivers. [1, 2, 3]. Globally, the pooled prevalence of Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD) among people living with T2D is 65 %. People living with MASLD, meanwhile, have an approximately 2.2-fold higher risk of developing T2D [3].
T2D is a form of diabetes in which the body becomes resistant to insulin and blood glucose levels become elevated. MASLD occurs when excess fat builds up in the liver as a result of these metabolic disturbances, particularly insulin resistance, excess body weight and poor blood glucose management.
Without treatment, MASLD can progress over time to more severe liver disease such as fibrosis and cirrhosis. One in five people living with T2D that have liver disease have advanced liver fibrosis.
Regional variation is marked with more than 80% of people living with T2D also living with MASLD in Eastern Europe compared to less than 70% in Western Europe [4, 5, 8].
Given their interconnectedness, a coordinated approach to the prevention, screening, early detection, and management of T2D and liver disease is essential. This is especially important because both liver disease and T2D develop silently. Many people remain undiagnosed until significant damage has already occurred. Early diagnosis offers the opportunity to prevent or delay progression to advanced liver disease, thereby improving quality of life and long-term outcomes.
Early detection needs to be accompanied by early and effective management. This should focus on addressing underlying metabolic risk factors, including through lifestyle interventions, weight management, and pharmacological treatment, as required. Newer therapies such as GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists, for example, have been shown to have beneficial effects on the management of both type 2 diabetes and liver disease, improving glycaemic control, promoting weight loss, and reducing liver fat [6, 7].