
Identifying NASH in Patients With Diabetes
What You Need to Know
Meeting Slides

Clinical Practice Guidelines
The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases.
Chalasani N, et al. Hepatology. 2018;67(1):328-357.
EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease.
European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), and European Association for the Study of Obesity (EASO). J Hepatol. 2016;64(6):1388-1402.
Clinical Resources
Histological Scoring System for Nonalcoholic Fatty Liver Disease.
Transplant Pathology Internet Services, 2009.
MELD Score (Model for End-Stage Liver Disease) (12 and older).
MD+CALC online calculator, 2016.
NAFLD (Non-Alcoholic Fatty Liver Disease) Fibrosis Score.
MD+CALC online calculator.
Fibrosis-4 (FIB-4) Index for Liver Fibrosis.
MD+CALC online calculator.
AST to Platelet Ratio Index (APRI).
MD+CALC online calculator.
Patient Resources
American College of Gastroenterology (ACG) Patient Education and Resource Center.
The ACG website provides a basic overview of NAFLD and includes patient-centered podcasts.
American Liver Foundation.
The American Liver Foundation website offers broad-based information and links to additional educational resources and support services for patients living with liver disease.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Health Information Center.
The NIDDK website for NAFLD and NASH provides comprehensive patient-centered information and resources, including an overview of clinical trial participation.
Suggested Readings
Nonalcoholic fatty liver disease incidence and impact on metabolic burden and death: a 20 year-community study.
Allen AM, et al. Hepatology. 2018;67(5):1726-1736.
Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN): a multicentre, double-blind, randomised, placebo-controlled phase 2 study.
Armstrong MJ, et al. Lancet. 2016;387(10019):679-690.
Non-alcoholic fatty liver disease: an expanded review.
Benedict M, Zhang X. World J Hepatol. 2017;9(16):715-732.
Management of nonalcoholic fatty liver disease in patients with type 2 diabetes: a call to action.
Bril F, Cusi K. Diabetes Care. 2017;40(3):419-430.
The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD).
Buzzetti E, et al. Metabolism. 2016;65(8):1038-1048.
Combination therapy of metformin and statin may decrease hepatocellular carcinoma among diabetic patients in Asia.
Chen HH, et al. Medicine (Baltimore). 2015;94(24):e1013.
Role of obesity and lipotoxicity in the development of nonalcoholic steatohepatitis: pathophysiology and clinical implications.
Cusi K. Gastroenterology. 2012;142(4):711-725.
Long-term pioglitazone treatment for patients with nonalcoholic steatohepatitis and prediabetes or type 2 diabetes mellitus: a randomized trial.
Cusi K, et al. Ann Intern Med. 2016;165(5):305-315.
Effect of canagliflozin treatment on hepatic triglyceride content and glucose metabolism in patients with type 2 diabetes.
Cusi K, et al. Diabetes Obes Metab. 2018;21(4):812-821.
Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: systematic review and meta-analysis.
Dulai PS, et al. Hepatology. 2017;65(5):1557-1565.
Components of metabolic syndrome increase the risk of mortality in nonalcoholic fatty liver disease (NAFLD).
Golabi P, et al. Medicine (Baltimore). 2018;97(13):e0214.
Noninvasive imaging methods to determine severity of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis.
Hannah WN Jr, Harrison SA. Hepatology. 2016;64(6):2234-2243.
A meta-analysis of randomized trials for the treatment of nonalcoholic fatty liver disease.
Musso G, Gambino R, Cassader M, Pagano G. Hepatology. 2010;52(1):79-104
Non-alcoholic fatty liver disease.
Neuschwander-Tetri BA. BMC Med. 2017;15(1):45.
Elafibranor, an agonist of the peroxisome proliferator-activated receptor-α and -δ, induces resolution of nonalcoholic steatohepatitis without fibrosis worsening.
Ratziu V, et al. Gastroenterology. 2016;150(5):1147-1159.
Cenicriviroc treatment for adults with non-alcoholic steatohepatitis: year 2 analysis of the phase 2b CENTAUR study.
Ratziu V, et al. J Hepatol. 2018;68(suppl 1):S1-S2.
Management of NAFLD: a stage-based approach.
Rinella ME, Sanyal AJ. Nat Rev Gastroenterol Hepatol. 2016;13(4):196-205.
Treatment of NAFLD with diet, physical activity and exercise.
Romero-Gómez M, et al. J Hepatol. 2017;67(4):829-846.
Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease.
Wong VW, et al. Hepatology. 2010;51(2):454-462.
Positive results from REGENERATE: a phase 3 international, randomized, placebo-controlled study evaluating obeticholic acid treatment for NASH.
Younossi Z, et al. J Hepatol. 2019;70(suppl 1):e5.
Relevant Resources
Mechanism-Based Strategies to Achieve Patient-Centered Care
Patient-Centered Management of Hyperglycemia in Primary Care
Integrating GLP-1 Receptor Agonists Into Multimodal Treatment Regimens
Translating Research Into Practice
Translating Reseach Into Practice
Overcoming Diagnostic Barriers and Optimizing Long-Term Patient Outcomes
Discussions and Debates Around GLP-1 Receptor Agonists
Evolving Roles of GLP-1 Receptor Agonists
Individualizing Evidence-Based Care
Best Practices in Combination Therapy
Evolving Approaches to Insulin Based Therapy
Best Practices in Diagnosis and Management
New Strategies for Insulin Replacement Therapy
Consensus and Controversies Around Intensifying Noninsulin Therapy
Clinical Updates in LDL-C Management
Improving Comprehensive Patient Care
An Evolving Role for Combinations of Injectable Antihyperglycemic Therapies
Integrating PCSK9 Inhibitors Into Hypercholesterolemia Management
Evolving Roles of GLP-1 Receptor Agonists
Looking Beyond Hemoglobin A1c
Mechanistic Insights and Evolving Treatment Options
Implications for PCSK9 Inhibitors in Clinical Practice
Cardiovascular and Renal Outcomes With SGLT2 Inhibitors
Reducing LDL-C and a Lifetime of Cardiovascular Risk