<b>Screening for Metabolic Dysfunction-Associated Steatotic Liver Disease in Patients With Type 2 Diabetes: Are We Doing Enough?</b>

<p dir="ltr"><b>OBJECTIVE. </b>Patients with type 2 diabetes are at an elevated risk for metabolic dysfunction-associated steatotic liver disease and advanced liver fibrosis. Multiple professional societies recommend initiating screening with a fibrosis-4 (FIB-4) index score calculation. This study aimed to evaluate the frequency of laboratory assessments necessary for FIB-4 score calculation in patients with type 2 diabetes.</p><p dir="ltr"><b>RESEARCH DESIGN AND METHODS. </b>A retrospective analysis of de-identified electronic medical records from 337,094<b> </b>patients aged 40–75 years with type 2 diabetes was conducted to evaluate the completion rate of FIB-4 scoring and adherence to other recommended measurements and medications, including urinary albumin measurement and statin use.</p><p dir="ltr"><b>RESULTS. </b>Only 33% of patients with type 2 diabetes had all necessary components for FIB-4 score calculation, although this rate increased significantly over time (odds ratio 2.51, 95% CI 2.44–2.58) in the period from 2020 to April 2024 compared with 2010–2014. Urinary albumin measurements also increased but remained low at 13% during the period from 2020 to April 2024. Prescriptions for statin and newer antihyperglycemic medications significantly increased.</p><p dir="ltr"><b>CONCLUSION. </b>Our findings indicate that, although testing frequency for liver health in patients with type 2 diabetes is gradually increasing, substantial gaps in clinical practice persist.</p>