Metabolic Dysfunction-Associated Steatotic Liver Disease in People with Type 1 Diabetes

Area of Science:

• Hepatology
• Endocrinology
• Metabolic Diseases

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly identified in type 1 diabetes (T1D) patients.
• Historically, MASLD was primarily linked to type 2 diabetes, but its presence in T1D warrants further investigation.

Purpose of the Study:

• To review the role of insulin resistance in MASLD development in T1D.
• To examine the association between MASLD and diabetes-related complications in T1D.
• To discuss prevalence, diagnostic challenges, and potential mechanisms of MASLD in T1D.

Main Methods:

• Literature review summarizing current research findings.
• Analysis of the relationship between insulin resistance, MASLD, and diabetes complications.
• Discussion of diagnostic modalities and emerging markers like estimated glucose disposal rate.

Main Results:

• Insulin resistance's role in T1D-associated MASLD requires more research, though markers like estimated glucose disposal rate show promise.
• MASLD in T1D is associated with microvascular (nephropathy, retinopathy, neuropathy) and macrovascular (cardiovascular disease) complications.
• Prevalence estimates vary due to inconsistent imaging techniques, underscoring the need for standardized diagnostics.

Conclusions:

• Recognizing and managing MASLD in T1D is crucial for preventing long-term complications.
• Addressing the links between MASLD, insulin resistance, and diabetes complications can improve patient outcomes.
• Standardized, non-invasive diagnostic tools are needed for accurate MASLD detection in T1D.