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Commentary
Treatment of type 2 diabetes with MASLD: new evidence for personalised medicine
  1. Cyrielle Caussy1,2
  1. 1 Centre Hospitalier Lyon Sud, Endocrinologie Diabète et Nutrition, Hospices Civils de Lyon, Pierre-Bénite, Auvergne-Rhône-Alpes, France
  2. 2 Univ Lyon, CarMen Laboratory, INSERM, INRA, INSA Lyon, Université Claude Bernard Lyon 1, Pierre-Bénite, Auvergne-Rhône-Alpes, France
  1. Correspondence to Dr Cyrielle Caussy, Centre Hospitalier Lyon Sud, Endocrinologie Diabète et Nutrition, Hospices Civils de Lyon, Pierre-Bénite, Auvergne-Rhône-Alpes, France; cyrielle.caussy{at}chu-lyon.fr

https://doi.org/10.1136/gutjnl-2024-333485

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    Metabolic dysfunction-associated steatotic liver disease (MASLD), is closely linked to type 2 diabetes (T2D).1 2 This strong association is due to shared pathophysiological pathways, including insulin resistance, mitochondrial dysfunction, adipose tissue dysfunction, low-grade inflammation and dysbiosis.3 The coexistence of MASLD and T2D affects the prognosis of both diseases in a bidirectional manner that is not yet fully understood.3 Given this connection, the impact of glucose-lowering therapies on MASLD has been an important area of investigation. Among these therapies, sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been associated with a decrease in liver fat content, liver enzymes and histological feature of metabolic dysfunction associated steatohepatitis (MASH) beyond their well-established cardio–renal benefits.

    In a study published in Gut, Mao et al performed a retrospective analysis of 399 126 patients diagnosed with T2D and MASLD, using US healthcare claims data from 2007 to 2021.4 The study used propensity score matching to compare long-term outcomes in patients treated with SGLT2i (15.7%) versus those treated …

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    Footnotes

    • Contributors CC: drafting of the manuscript, critical revision of the manuscript and approved the final version of this article. CC is the guarantor of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests CC received consultant fees from Gilead, Novo Nordisk, AstraZeneca, Lilly, E-scopics, MSD, Bayer, Corcept and Echosens; grant support from Gilead, Echosens and Novo Nordisk.

    • Provenance and peer review Commissioned; internally peer reviewed.

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