P90 Effectiveness of a multidisciplinary hepatology-diabetes clinic in managing patients with metabolic dysfunction-associated steatotic liver disease and type 2 diabetes mellitus

<h3>Background</h3> Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Type 2 Diabetes Mellitus (T2DM) frequently coexist, affecting approximately 25% and 6.6% of the global population respectively.¹ The bidirectional pathophysiological relationship between these conditions necessitates integrated management approaches. Current healthcare models often address these conditions in isolation, potentially compromising optimal patient outcomes. This study evaluates the clinical effectiveness of a novel multidisciplinary hepatology-diabetes clinic model. <h3>Methods</h3> A retrospective cohort study was conducted involving 34 patients with concurrent MASLD and T2DM attending a combined hepatology-diabetes clinic. Primary outcome measures included Body Mass Index (BMI), Haemoglobin A1c (HbA1c), Alanine Aminotransferase (ALT), Fibrosis-4 Index (FIB-4), and liver stiffness measured by transient elastography. Clinical parameters were assessed at baseline and 6 months post-clinic attendance. Statistical analysis employed paired t-tests to determine significance of parameter changes, with p&lt;0.05 considered statistically significant. <h3>Results</h3> Significant improvements were observed across multiple clinical parameters at 6-month follow-up. ALT levels improved in 73% of patients, demonstrating a mean reduction of 5.77 U/L (32.12% decrease, p=0.022). Universal improvement (100%) was observed in FIB-4 scores, with a mean reduction of 0.5 units (40.32% decrease, p=0.030). Liver stiffness improved in all patients, showing a mean reduction of 4.33 kPa (42.37% decrease, p=0.175). BMI improved in 73% of patients with a mean reduction of 1.265 kg/m² (10.00% decrease, p=0.147). HbA1c demonstrated improvement in 52% of patients, with a mean reduction of 5.704 mmol/mol (23.00% decrease, p=0.050). Statistically significant improvements were achieved for ALT, FIB-4, and HbA1c parameters. <h3>Conclusion</h3> This multidisciplinary care model integrating hepatology and diabetology expertise demonstrates significant clinical benefits in managing patients with concurrent MASLD and T2DM. The observed improvements in liver function markers, fibrosis indices, and glycaemic control suggest enhanced hepatic insulin sensitivity and reduced hepatic steatosis. These findings support the implementation of integrated care models for patients with metabolic syndrome, though larger prospective studies are warranted to validate these preliminary results and establish optimal care pathways. <h3>Reference</h3> Zheng H, Sechi LA, Navarese EP, Casu G, Vidili G. Metabolic dysfunction-associated steatotic liver disease and cardiovascular risk: a comprehensive review. <i>Cardiovascular Diabetology</i>. 2024 Sep 28;23(1).