New research from Karolinska Institutet in Sweden suggests the potential for screening individuals with type 2 diabetes for liver damage alongside their regular eye disease screenings. The study, published in The Lancet Gastroenterology and Hepatology, explores the possibility of detecting advanced liver fibrosis in diabetic patients using elastography, a painless, ultrasound-based technique.
More than half of people with type 2 diabetes have steatotic liver disease, a condition where fat builds up in the liver, often without symptoms in its early stages. Over time, it can lead to liver fibrosis, a form of scarring that can progress to cirrhosis or liver cancer. Despite the widespread presence of this condition, liver disease is often diagnosed too late when treatment options are limited.
Hannes Hagström, adjunct professor at Karolinska Institutet and consultant in hepatology, highlighted the importance of early detection, noting that approved treatments for steatotic liver disease with fibrosis could prevent more severe outcomes. “It would be beneficial to screen diabetic patients for liver fibrosis and intervene before the disease progresses to cirrhosis or liver cancer,” he said.
In Sweden, retina scanning is already an established screening tool for eye damage in people with type 2 diabetes. The new study investigates whether liver fibrosis could be screened for simultaneously during eye exams, using elastography. The technique, which takes just 5 to 10 minutes, could help detect liver fibrosis early, allowing for timely intervention.
As reported by medicalxpress, the study involved over 1,300 patients with type 2 diabetes who had retina scans. When asked if they would also consent to liver screening, 77% of participants agreed. Of those who underwent elastography, 15.8% showed signs of liver fibrosis, while 5.0% had advanced liver fibrosis or cirrhosis. However, follow-up examinations revealed lower rates of liver disease, suggesting that some initial results may have been false positives.
Despite this, the research shows that a combined screening for both eye and liver diseases could be feasible and well-accepted by patients. Hagström stated that the next step would be to conduct health-economic analyses to determine the cost-effectiveness of this combined screening approach for preventing severe liver disease in type 2 diabetes patients.