ReviewDiabetologia2026
Screening and diagnosis of liver disease in diabetes: a guide and evidence-based assessment.
Review in Diabetologia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- The liver in diabetes: current state and future perspectives.Diabetologia · 2026Review
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Most people with type 2 diabetes have metabolic dysfunction-associated steatotic liver disease (MASLD), yet fewer than 2% experience major adverse liver outcomes within 10 years. Because progression to end-stage liver disease is uncommon, identifying the small subset of individuals at highest risk remains a central clinical challenge. Liver fibrosis is the strongest prognostic determinant in MASLD, and a range of blood-based and imaging tests are used to assess the likelihood of advanced fibrosis (AF) in the clinic. Since 2023, major medical societies have recommended systematic screening for MASLD-related AF in individuals with type 2 diabetes, driven by reports suggesting a high prevalence of up to 20-40%. This review critically examines the evidence underlying these recommendations while providing a clinically oriented guide to diagnosing MASLD in type 2 diabetes. Re-analysis of data from prevalence studies suggests that the burden of AF in type 2 diabetes has been substantially overestimated and may be below 5-10%, which has profound implications for both the rationale for screening and its expected yield. Simulations and emerging real-world evidence suggest that current non-invasive tests may refer 30-50% of patients for costly second-line testing and 15% for specialist evaluation, while generating high false-positive rates and missing more than a third of all AF cases. Moreover, it remains uncertain whether diagnosing AF in type 2 diabetes currently leads to meaningful changes in management or outcomes. Existing cost-effectiveness analyses rely on assumptions about disease burden and therapeutic benefit that are not supported by available data. Together, these considerations call for a more rigorous, evidence-based approach to evaluating liver disease risk in type 2 diabetes and other populations.
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