A machine learning-based classification of adult-onset diabetes identifies patients at risk of liver-related complications

Exploring the links between types 2 diabetes and liver‐related complications: A comprehensive review

“…By applying a novel clustering‐based classification of adult‐onset diabetes, 25 a recent cohort study reported that severe insulin‐resistant diabetes emerged as the highest‐risk subgroup of patients for liver‐related events and advanced fibrosis 22 . Furthermore, this study also identified excessive alcohol consumption, even at the time of diabetic diagnosis, as a main risk factor for liver‐related events.…”

“…However, only a small fraction of patients with T2DM will develop liver‐related complications, including cirrhosis decompensation and HCC development. In a recent cohort study, including 82% of T2DM and 18% of type 1 diabetes mellitus without evidence of advanced liver disease at baseline, the cumulative incidence of liver‐related events at 10‐years was 0.34% 22 . The 10‐year cumulative incidence of the liver‐related event reports in a recent study enrolling 7028 patients with MASLD and T2DM (including 6.4% of cirrhotic patients at baseline) was 0.6% 23 .…”

“…In a recent cohort study, including 82% of T2DM and 18% of type 1 diabetes mellitus without evidence of advanced liver disease at baseline, the cumulative incidence of liver‐related events at 10‐years was 0.34%. 22 The 10‐year cumulative incidence of the liver‐related event reports in a recent study enrolling 7028 patients with MASLD and T2DM (including 6.4% of cirrhotic patients at baseline) was 0.6%. 23 Although the cumulative incidence of liver‐related events is low in the population with T2DM, the high prevalence of the disease still translates into a significant number of individuals who will develop liver‐related complications.…”

Risk factors associated with liver‐related complications in diabetes: There may be more than meets the eye

“…The authors reported that alcohol use disorders accounted for more than half of the attributable risk fraction for liver‐related complications, while features of the metabolic syndrome (i.e., obesity) contributed to less than 10%. Another cohort study, which followed 1068 diabetic patients for 15 years, suggests that a more pronounced insulin‐resistant profile and excessive alcohol consumption at diabetes diagnosis, rather than an elevated body mass index, were the main risk factors associated with subsequent liver‐related events 9 . Considering the pivotal role of alcohol consumption as a risk factor for liver complications in both diabetic and non‐diabetic dysmetabolic populations, there is a pressing need to evaluate precise scales for quantifying alcohol consumption.…”

“…Another cohort study, which followed 1068 diabetic patients for 15 years, suggests that a more pronounced insulin‐resistant profile and excessive alcohol consumption at diabetes diagnosis, rather than an elevated body mass index, were the main risk factors associated with subsequent liver‐related events. 9 Considering the pivotal role of alcohol consumption as a risk factor for liver complications in both diabetic and non‐diabetic dysmetabolic populations, there is a pressing need to evaluate precise scales for quantifying alcohol consumption. In line with this, a recent study revealed that 29% of patients classified initially as MAFLD had relevant alcohol intake when assessed using objective alcohol markers.…”