Summary
People with type 2 diabetes mellitus (T2DM) have increased risk of dysmetabolic liver disease and liver fibrosis, linked with increased morbidity and mortality. In recent years, non-invasive methods for assessment of liver fibrosis in people with T2DM have been developed. Concurrently, referral recommendations to hepatologists are being refined and new treatments for liver fibrosis in dysmetabolic disease such as T2DM are being developed. International clinical care guidelines for assessment and management of liver fibrosis in diabetes have been developed, reflecting an increasing evidence base. This Australian Diabetes Society (ADS) living clinical guideline has both adapted an international clinical care guideline to the Australian situation and harnessed expert consensus through a modified Delphi process. The consequent 14 recommendations target an endocrinology audience managing a defined patient phenotype and have been integrated with the 2024 published collaborative Gastroenterology Society of Australia (GESA) consensus statement for patient assessment in primary care. It is envisaged that these ADS living guidelines will assist endocrinologists/diabetologists to develop local liver assessment, referral and treatment pathways for their patients with T2DM.

Position Statement
Download the ADS Clinical Care Consensus Living Guideline for Specialist Assessment, Referral and Treatment of Metabolic Dysfunction-Associated Fatty Liver Disease in People with Diabetes (June 2025) – PDF