The ADA Recommends Screening For Nonalcoholic Fatty Liver Disease In All Diabetic Patients.
The American Diabetes Association issued a statement on Sunday stating that all adults with type 2 diabetes or prediabetes should undergo screening for nonalcoholic fatty liver disease, a condition that is becoming increasingly common and can result in severe damage to the liver.
According to the recommendations that were published during the annual ADA conference, there are no medications that have been approved for the condition; however, among the diabetes medications that are currently available, the American Diabetes Association (ADA) singled out GLP-1 treatments as one option that doctors could take into consideration.
GLP-1 medicines, like Ozempic and Mounjaro, are a class of medications that have become broadly famous for their viability in bringing down glucose, yet in addition cutting weight. They have begun to be studied by pharmaceutical companies for liver disease; however, despite the fact that some trials have demonstrated that they may provide some benefits, they have not yet been demonstrated to reduce harmful liver scarring.
According to Robert Gabbay, chief science and medical officer of the ADA, “we realized this is just becoming such a pervasive issue,” the organization published recommendations regarding the disease. In many ways, obesity and type 2 diabetes are becoming the leading causes of liver disease, but this is not something that people who are thinking about diabetes really consider.
About 24% of adults in the United States are thought to have nonalcoholic fatty liver disease, which occurs when excess fat builds up in the liver. Nonalcoholic steatohepatitis, or NASH, is a severe, rare form of liver inflammation and scarring that has become one of the leading causes of liver transplantation and liver cancer.
Despite the increasing prevalence of the condition, no medications have been approved to treat it. A NASH treatment from Intercept Pharmaceuticals was turned down by the Food and Drug Administration just this past week after advisers to the agency raised safety concerns.
In the new proposals, the ADA said all diabetes patients ought to be screened with what’s known as a fibrosis-4 record, which is determined in view old enough and standard blood proportions of ALT, AST, and platelet count.
The enhanced liver fibrosis test and the measurement of liver stiffness are two additional tests that should be given to people who have a high index. According to the ADA, they ought to be referred to a gastroenterologist or hepatologist if it is determined that they are at a high risk for the scarring of the liver known as fibrosis.
According to the ADA, after a patient is given a diagnosis of the disease, their doctor should advise them to make lifestyle changes to lose weight and think about prescribing a GLP-1 medication. Additionally, the group suggested pioglitazone, an older diabetes medication that has been shown in some studies to aid in disease management.
The ADA stated that while other diabetes medications may continue to be used to lower blood sugar, there is insufficient evidence that they aid in fatty liver disease.
Additionally, there is still a lack of data on the effectiveness of GLP-1s in fatty liver disease. Ozempic’s active ingredient, semaglutide, was found to be associated with a higher rate of NASH resolution in one trial, but it did not significantly improve liver scarring, which is an important consideration for regulators when reviewing liver disease treatments.
Other drugs for NASH that may be more effective than GLP-1s are also in development. Akero Therapeutics’ experimental drug was found to be more effective than a GLP-1 on its own in reducing liver fat and improving markers of liver scarring in a recent small study.
However, newer GLP-1 medications that are currently in development may have a better chance of preventing fatty liver disease. This week, Merck presented data demonstrating that its experimental drug, which targets both the GLP-1 and glucagon hormones, reduced liver fat more effectively than semaglutide. In NASH patients, Boehringer Ingelheim is also testing a drug that targets GLP-1 and glucagon.