Referral to hepatologists or a second-line examination requirement is common in patients with type 2 diabetes mellitus

Abstract

Background and aimsTo estimate the number of patients who required a referral to hepatologists following the 2016 EASL–EASD–EASO guideline and a second-line vibration controlled transient elastography (VCTE) examination following the 2021 EASL guideline according to obesity, glycated hemoglobin (HbA1c), blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C) control status in patients with type 2 diabetes mellitus (T2DM). Methods and resultsA total of 2515 T2DM patients who were hospitalized were cross-sectionally assessed. When we applied the 2016 EASL–EASD–EASO guideline, 26.8 %–46.4 % (depending on the scores used for diagnosing fibrosis) of T2DM patients needed a referral to hepatologists. When we applied the 2021 EASL guideline, a VCTE examination was required in 10.9 %–35 % (depending on the scores used for diagnosing fibrosis) of T2DM patients. The referral rates and the VCTE requirement were even higher in patients who were obese and/or had poor HbA1c, BP, and/or LDL-C control. ConclusionsApplication of the screening guidelines would lead to a referral to hepatologists or a second-line VCTE examination requirement for a substantial number of T2DM patients, regardless of obesity and metabolic goal attainment status.