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Anstalt \u00f6ffentlichen Rechts","id":[{"id":"https:\/\/ror.org\/006k2kk72","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Diabetologia"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Diabetes mellitus is strongly associated with metabolic dysfunction-associated steatotic liver disease (MASLD). For many years, MASLD has not been recognised as either a common pathophysiological feature of type 2 diabetes or a diabetes-related complication. This special issue of\n                    <jats:italic>Diabetologia<\/jats:italic>\n                    puts the liver in focus in the context of diabetes. This review discusses current challenges in, and emerging opportunities for, the diagnosis and management of MASLD and fibrosis in type 2 diabetes. Up to 95% of cases of MASLD remain undiagnosed because there are no accepted recommendations for assessing steatosis, whereas non-invasive tests overestimate the prevalence of MASLD progression in type 2 diabetes. Of note, the combination of type 2 diabetes and metabolic syndrome features is a strong predictor of liver disease outcomes, but CVD is the major cause of death in non-cirrhotic MASLD. MASLD is heterogeneous including subtypes linked to common genetic variants, for example\n                    <jats:italic>PNPLA3<\/jats:italic>\n                    I148M, which increases the risk of liver disease but may protect against CVD. Recent approval of drugs targeting hepatic energy metabolism or promoting weight loss is promising for achieving fibrosis remission, but people with type 2 diabetes will still require complex multifactorial management. Achieving a significant increase in diagnostic rates of at-risk metabolic dysfunction-associated steatohepatitis (MASH) will require a paradigm shift, including greater awareness among clinicians, including diabetologists and endocrinologists, and expansion of community-based diagnostic capabilities accompanied by analyses of the cost-effectiveness of prevention and treatment.\n                  <\/jats:p>","DOI":"10.1007\/s00125-026-06827-x","type":"journal-article","created":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T16:15:24Z","timestamp":1786810524000},"page":"3021-3033","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The liver in diabetes: current state and future perspectives"],"prefix":"10.1007","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6766-1549","authenticated-orcid":false,"given":"Hannele","family":"Yki-J\u00e4rvinen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8200-6382","authenticated-orcid":false,"given":"Michael","family":"Roden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,15]]},"reference":[{"key":"6827_CR1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-026-06724-3","author":"N Segev","year":"2026","unstructured":"Segev N, Mouzaki M (2026) Updates on paediatric MASLD: insights from an endocrine lens. 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Kr\u00e4mer at the German Diabetes Center (DDZ) for helping with the organisation of the references.","order":1,"name":"Ethics","label":"Acknowledgements","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"Open Access funding enabled and organized by Projekt DEAL. MR\u2019s research is supported in part by the German Diabetes Center (DDZ), which is funded by the German Federal Ministry of Health (Berlin, Germany) and the Ministry of Culture and Science of the state of North Rhine-Westphalia (D\u00fcsseldorf, Germany), by grants from the German Federal Ministry of Research, Technology and Space (Berlin, Germany) to the German Center for Diabetes Research e.V. (DZD e.V.), and by grants from the Schmutzler Stiftung, the German Research Foundation (DFG) (CRC 1774) and the European Community (HORIZON-HLTH-2022-STAYHLTH-02\u201301: Panel A) to the INTERCEPT-T2D consortium.","order":2,"name":"Ethics","label":"Funding","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"HY-J has received fees for consulting from Novartis, Novo Nordisk, Eli Lilly, Hanmi Pharmaceuticals and MSD. MR has received fees for consulting or lecturing from Astra Zeneca, Boehringer Ingelheim, Echosens, Eli Lilly, Madrigal, MSD, Novo Nordisk, Sanofi, Synlab and Target RWE and has performed investigator-initiated research with support from Boehringer Ingelheim and Novo Nordisk.","order":3,"name":"Ethics","label":"Authors\u2019 relationships and activities","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"Both authors were responsible for drafting the article and reviewing it critically for important intellectual content. Both authors approved the version to be published.","order":4,"name":"Ethics","label":"Contribution statement","group":{"name":"EthicsHeading","label":"Ethics"}}]}}