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A personalized treatment program in persons with type 2 diabetes is associated with a reduction in liver steatosis

Karl Björkström1, Per Stål1,2, Magnus Holmer1,2

  • 1Department of Medicine, Huddinge, Karolinska Institutet.

European Journal of Gastroenterology & Hepatology
|August 16, 2020
PubMed
Abstract

Insights

Improving glycemic control in type 2 diabetes (T2D) patients through personalized programs can reduce liver steatosis and stiffness. This study shows a link between better glucose management and improved liver health in advanced T2D.

Area of Science:

  • Hepatology
  • Endocrinology
  • Metabolic Diseases

Background:

  • The impact of glycemic control on liver health in type 2 diabetes (T2D) is not fully understood.
  • Non-alcoholic fatty liver disease (NAFLD) and advanced fibrosis are prevalent in individuals with advanced T2D.

Purpose of the Study:

  • To investigate the association between a personalized treatment program aimed at improving glycemic control and liver-related parameters in patients with advanced T2D.
  • To evaluate the real-life effectiveness of such interventions on liver steatosis and fibrosis.

Main Methods:

  • A 4-day personalized treatment program focusing on diet, glucose control education, and medication adjustment was implemented for advanced T2D patients.
  • Transient elastography, including controlled attenuation parameter (CAP) for steatosis and liver stiffness measurement (LSM) for fibrosis, was used.
  • Exclusion criteria included liver diseases other than NAFLD; follow-up assessments were conducted after 3 months.

Main Results:

  • Out of 91 participants, 75 had quality CAP measurements, with 57 (76%) diagnosed with NAFLD.
  • Twenty-two participants (24%) exhibited elevated liver stiffness, and 8 (9%) had advanced fibrosis.
  • A median follow-up of 101 days showed a significant reduction in mean CAP (18.33 dB/m, P=0.035) and liver stiffness (2.6 kPa, P=0.047) in relevant subgroups.
  • Improved fasting glucose levels correlated with reduced hepatic steatosis (adjusted R2=0.35, P<0.01).

Conclusions:

  • A high prevalence of NAFLD with advanced fibrosis exists in advanced T2D patients.
  • Personalized glycemic control interventions are associated with significant improvements in liver steatosis and stiffness in this population.
  • Targeting glycemic control may be a viable strategy for managing liver-related complications in T2D.

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