{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:43:55Z","timestamp":1785545035308,"version":"3.56.0"},"reference-count":34,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The mortality rate from liver disease among people with type 2 diabetes mellitus (T2DM) increased by 20% between 2001 and 2018. There are marked racial and ethnic differences among people with T2DM at risk of metabolic dysfunction\u2013associated steatotic liver disease (MASLD) and related complications.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n We aimed to investigate the distribution of individual-level social determinants of health (SDOH) in people living with both T2DM and MASLD.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this small cross-sectional study, patients (N=50) were recruited from a tertiary care general hepatology clinic to complete a survey that assessed potential determinants of health. We sought to oversample Black and Hispanic patients to better understand the prevalence of SDOH. Electronic health records were reviewed to determine stage of liver disease, and these data were linked to survey results to identify the distribution of individual-level determinants of health in patients with cirrhosis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Black and Hispanic respondents were more likely to report more experiences of racial discrimination, worries about being discriminated against, and group-based medical mistrust, especially regarding unsupportive health care providers. Cirrhosis groups tended to have lower incomes and less coverage from private health insurance. However, no substantial trends were observed in the distribution of health literacy, discrimination, and diabetes stigma among patients with and without cirrhosis.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n These findings will inform a future study aimed at assessing and developing interventions to address the combined impact of individual- and neighborhood-level SDOH on health-related outcomes in patients with T2DM and MASLD.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/91608","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T21:43:07Z","timestamp":1781559787000},"page":"e91608-e91608","source":"Crossref","is-referenced-by-count":0,"title":["Characterizing Social Determinants of Health in Patients With Type 2 Diabetes and Liver Disease: Cross-Sectional Survey Study"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6711-1761","authenticated-orcid":false,"given":"Parnnate","family":"Wongsirisakul","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0157-6066","authenticated-orcid":false,"given":"Vincent Lingzhi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1183-8330","authenticated-orcid":false,"given":"Jonathan","family":"Troost","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3070-3906","authenticated-orcid":false,"given":"Ponni","family":"Perumalswami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1007\/s11606-021-06677-w","article-title":"Prevalence of nonalcoholic fatty liver disease and hepatic fibrosis among US adults with prediabetes and diabetes, NHANES 2017-2018","volume":"37","author":"Kim","journal-title":"J Gen Intern Med"},{"issue":"3","key":"R2","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1016\/j.jhep.2022.11.010","article-title":"A prospective study on the prevalence of NAFLD, advanced fibrosis, cirrhosis and hepatocellular carcinoma in people with type 2 diabetes","volume":"78","author":"Ajmera","journal-title":"J Hepatol"},{"issue":"3","key":"R3","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/S2213-8587(20)30431-9","article-title":"Trends in predominant causes of death in individuals with and without diabetes in England from 2001 to 2018: an epidemiological analysis of linked primary care records","volume":"9","author":"Pearson-Stuttard","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"5","key":"R4","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.1002\/hep.32476","article-title":"Risk of liver-related events by age and diabetes duration in patients with diabetes and nonalcoholic fatty liver disease","volume":"76","author":"Zhang","journal-title":"Hepatology"},{"issue":"4","key":"R5","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1002\/hep.32743","article-title":"Health disparities in chronic liver disease","volume":"77","author":"Kardashian","journal-title":"Hepatology"},{"issue":"12","key":"R6","doi-asserted-by":"publisher","first-page":"2790","DOI":"10.1016\/j.cgh.2021.11.029","article-title":"Food insecurity is associated with mortality among U.S. adults with nonalcoholic fatty liver disease and advanced fibrosis","volume":"20","author":"Kardashian","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"5","key":"R7","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1111\/apt.17631","article-title":"Effects of social determinants of health on mortality and incident liver-related events and cardiovascular disease in steatotic liver disease","volume":"58","author":"Chen","journal-title":"Aliment Pharmacol Ther"},{"issue":"9","key":"R8","doi-asserted-by":"publisher","first-page":"1608","DOI":"10.2105\/AJPH.2006.102525","article-title":"Approaching health disparities from a population perspective: the National Institutes of Health Centers for Population Health and Health Disparities","volume":"98","author":"Warnecke","journal-title":"Am J Public Health"},{"issue":"1","key":"R9","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1158\/1055-9965.EPI-17-0945","article-title":"Multilevel examination of health disparity: the role of policy implementation in neighborhood context, in patient resources, and in healthcare facilities on later stage of breast cancer diagnosis","volume":"28","author":"Warnecke","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"Suppl 1","key":"R10","doi-asserted-by":"publisher","first-page":"S17","DOI":"10.2337\/dc22-S002","article-title":"2. 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