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MASLD as Complication of Diabetes
Norbert Stefan1,2,3
1Internal Medicine IV, Department of Diabetology, Endocrinology and Nephrology, University Hospital of Tübingen, Tübingen, Germany.
Diabetes
|June 6, 2026
Summary
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major liver disease linked to type 2 diabetes. Early screening and treatment, including specific medications, are crucial for managing MASLD in diabetic patients.
Area of Science:
- Hepatology
- Endocrinology
- Metabolic Diseases
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease globally.
- MASLD is highly prevalent in individuals with type 2 diabetes (65% in adults, 37% in children).
- MASLD shares pathogenic mechanisms with type 2 diabetes, including hyperglycemia, hyperinsulinemia, and hyperlipidemia.
Purpose of the Study:
- To discuss the pathogenesis of MASLD and its relationship with type 2 diabetes.
- To explore MASLD pathophysiology heterogeneity and risk stratification.
- To advocate for specific pharmacotherapies in MASLD patients with type 2 diabetes.
Main Methods:
- Review of major pathogenetic mechanisms linking MASLD and type 2 diabetes.
- Discussion of MASLD pathophysiology and potential patient stratification clusters.
- Analysis of hepato-, cardio-, and nephroprotective effects of specific drug classes.
Main Results:
- MASLD pathogenesis is intricately linked to type 2 diabetes.
- MASLD is increasingly viewed as a complication of diabetes.
- Sodium-glucose cotransporter 2 inhibitors and GLP-1 receptor agonists show promise.
Conclusions:
- MASLD requires integration into clinical diabetes management.
- Further research into MASLD pathophysiology and risk stratification is needed.
- SGLT2 inhibitors and GLP-1 RAs are recommended as first-line treatments for MASLD and type 2 diabetes.
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