Current Status and Issues of Screening Fatty Liver and Liver Cancer by Diabetologists: A Questionnaire Survey of Diabetologists in Nagano Prefecture, Japan

Abstract

This study determined the current status and clarified issues regarding screening of patients with fatty liver and liver cancer via a survey of diabetologists in Nagano Prefecture, Japan. The questionnaire focused on non-alcoholic fatty liver disease (NAFLD), a condition closely associated with diabetes mellitus. Responses were received from 44 out of 69 diabetologists surveyed (response rate: 64 %). Approximately 90 % of respondents stated that the interval of measuring liver function tests and platelets was 6 months or shorter, and only 64 % calculated the FIB-4 index, indicating a gap between evidence-based practice and their routine medical practice. Furthermore, 73 % of respondents performed imaging tests at their own institutions, and the rate was significantly higher for diabetologists working in hospitals than those working in clinics. At least 50 % of respondents had managed patients with diabetes-associated liver cancer, and some also suggested collaborating with gastroenterologists. Diabetologists play a crucial role in the treatment of patients with NAFLD. Therefore, our results highlight the need to inform diabetologists about NAFLD fibrosis screening and its implementation and to establish an evaluation system that includes imaging tests and collaboration with gastroenterologists.