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S1-E1 - New Podcast: Growing NAFLD-Diabetes Dual Prevalence Increases CVD Risk for Diabetics

S1-E1 – New Podcast: Growing NAFLD-Diabetes Dual Prevalence Increases CVD Risk for Diabetics

In this Premier episode of The NASH Tsunami in Diabetes: Getting Ahead of the Rising Tide, key opinion leaders Doctors Stephen Harrison, Kathleen Corey and Kay Pepin join co-hosts Dr. Ken Cusi and Roger Green to discuss key issues related to the NAFLD-Diabetes Link, NAFLD-Diabetes Dual Prevalence: very high NAFLD and NASH prevalence in diabetics leads to increased CVD risk and other metabolic issues.

The NASH Tsunami in Diabetes: Getting Ahead of the Rising Tide is a new podcast series for healthcare professionals who treat diabetic patients, the patients themselves and their caregivers. Episode 1 introduces some of the research that has led AACE to issue guidelines, AGA to propose clinical care pathways and AHA to produce a white paper on the links between Fatty Liver Disease and CVD Risk.

Did you know?

  • 15% of diabetic patients might have fibrosis.
  • In one study, 70% diabetics had fatty liver and 35% had NASH?
  • 25% of deaths in people with NAFLD are cardiovascular disease?
  • NAFLD is an independent risk factor for development of diabetes, cardiovascular disease, and chronic kidney disease.

NAFLD-Diabetes Dual Prevalence

First, hepatology researcher and key opinion leader Dr. Stephen Harrison reviews the results of his 2021 paper, Prospective Evaluation of the Prevalence of Non-Alcoholic Fatty Liver Disease and Steatohepatitis in a Large Middle-Aged US Cohort. This paper asked over 800n seemingly healthy people with no reported liver issues who were receiving a colonoscopy if they would like to have their livers evaluated at the same time. In this apparently healthy population, 37% tested positive for NAFLD and 14% tested positive for biopsy-confirmed NASH. Among Type 2 diabetics, the corresponding numbers were 70% with NAFLD and 35% with NASH. All these numbers are higher than previously reported estimates derived retrospectively from secondary databases.

Next, endocrinology researcher and key opinion leader Ken Cusi discusses s his work looking at NAFLD and NASH in diabetic patient populations. He discusses studies confirming that patients with diabetes are at least twice as likely to have NAFLD or NASH as non-diabetics. He notes that this effect is confirmed in overweight as well as obese patients and is proven independent of obesity (NOTE: the two together are worse than either alone). In practical terms, he notes that primary care and endocrinology clinics are the places we can identify NAFLD and early NASH before these become later-stage fibrosis or cirrhosis requiring attention from hepatologists. In that context, he notes that twice as many patients in an endocrinology clinic will test positive for NAFLD or NASH compared to a primary care clinic, thus making endocrinologists a vital target group for earlier identification and treatment of Fatty Liver Disease. In his practice, Ken advocates for every patient to receive a FIB-4 test, which can be found in most EMR systems and is an inexpensive, reasonably reliable negative predictor for F3 or F4 status.

Next, hepatology researcher and key opinion leader Kathleen Corey discusses some of her research on the link between CVD and NAFLD. Two key conclusions: over a relatively short period after initial induction into the study (median of 25.5 months), the presence of NAFLD causes a 70% increase in relative risk (4.1% vs. 2.6%) of a Major Adverse Cardiovascular Event (MACE). She agrees with Ken’s suggestion about FIB-4. She also notes the trend of primary care physicians to discontinue statins if the patient’s ALT level starts to rise and cautions that this step is likely to increase patient risk.

Finally, Kay Pepin, Director of Research Translation for Resoundant Inc. under joint appointment with the Mayo Clinic, discusses research demonstrating that a relatively simple MRE session can provide the information necessary to determine the likelihood that fibrosis will advance to cirrhosis or compensated cirrhosis will advance to decompensated states. She also notes that with insurance coverage, this is not an expensive test for many people. By adding a simple MRI module to the MRE session, physicians can derive a significant amount of additional information.

This podcast series and all the episodes are produced under a non-restricted grant from Novo Nordisk. Novo Nordisk has neither influenced nor reviewed the contents of this podcast in any way. This content represents the views of the speakers and does not necessarily represent the views of Novo Nordisk. The content herein is for educational purposes only and should not be taken as medical advice.

S2-5 – Key Insights from the American Diabetes Association 83rd Scientific Sessions

Ken Cusi and Roger Green are joined by family practice researcher and KOL Eric Johnson and diabetologist and primary care KOL Jay Shubrook in a discussion around exciting news emerging from the ADA 83rd Scientific Sessions meeting. Layering in practical takeaways, the group explores their impressions from the meeting, the utility of FIB-4 as a frontline screening tool, guidelines and recommendations, therapeutic options both now and in the imminent future, and lastly the new nomenclature rollout for Fatty Liver disease.

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S2-E3 – Why Clinical Care Pathways Matter

In this episode of the Rising Tide series, co-hosts Ken Cusi and Roger Green are joined by KOL in public health, Jeff Lazarus, and physician and associate professor of internal medicine, Jeff Budd. The panelists focus on why clinical care pathways matter and drive the message that primary care plays an integral role in fighting fatty liver.

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S2-E2 – A Deeper Dive Into Fatty Liver, NAFLD, and NASH

In this episode of the Rising Tide series for frontline professionals, the patients themselves and caregivers, co-hosts Ken Cusi and Roger Green are joined by KOL in hepatology, Manal Abdelmalek and KOL in endocrinology, Scott Isaacs for a deeper dive into Fatty Liver, NAFLD and NASH. The group discusses: morbidities and mortalities related to fatty liver disease, paradigm-shifting data, screening for risk stratification, pediatric and adolescent populations, unique key takeaways and much more.

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S2-1 – Combating Swelling NAFLD and NASH Prevalence: Drugs, Diagnostics and Guidelines for the Frontline

In the Season 2 debut of the Rising Tide series for healthcare professionals who treat diabetic patients, the patients themselves and their caregivers, co-hosts Ken Cusi and Roger Green are joined by Mazen Noureddin to talk about prevalence and taking action on the frontlines today. The trio explore emerging NASH drugs, noninvasive testing and guidelines for treating different stages of disease progression.

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S1-E2 — What’s Behind The New AACE Fatty Liver Guidelines?

Drs. Mary Rinella, Zobair Younossi and Diana Barb join co-hosts Dr. Ken Cusi and Roger Green to explore the new AACE Fatty Liver guidelines. Learn about the epidemiology and research behind the guidelines and what they recommend for endocrinologists, primary care physicians and allied health professionals when screening, diagnosing and managing Type 2 Diabetes patients for Fatty Liver disease.

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S1-E1.1 – Fatty Liver Prevalence May Be Higher Than Previously Thought, Especially Among Type 2 Diabetes Patients

Hepatology Researcher and Key Opinion Leader Stephen Harrison discussed results of his 2021 publication in the Journal of Hepatology that reported, in a prospective random sample of 835 people with a median age of 55, NAFLD prevalence as being 37%, NASH as being 14% and advanced fibrosis as being 6% in a random asymptomatic patients. Among patient with Type 2 Diabetes, NAFLD prevalence was 70% and NASH was 35%.

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S1-E1 – New Podcast: Growing NAFLD-Diabetes Dual Prevalence Increases CVD Risk for Diabetics

In this Premier episode of The NASH Tsunami in Diabetes: Getting Ahead of the Rising Tide, key opinion leaders Doctors Stephen Harrison, Kathleen Corey and Kay Pepin join co-hosts Dr. Ken Cusi and Roger Green to discuss key issues related to the NAFLD-Diabetes Link, NAFLD-Diabetes Dual Prevalence: very high NAFLD and NASH prevalence in diabetics leads to increased CVD risk and other metabolic issues.

jump to episode >

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Welcome to the world's leading source for Fatty Liver podcasts, with close to 500 episodes and conversations with the world's leading Key Opinion Leaders. Listen, learn, participate.

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