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S2-4 - What Can You Do Today to Prevent and Treat Fatty Liver Disease?

S2-4 – What Can You Do Today to Prevent and Treat Fatty Liver Disease?

Ken Cusi and Roger Green are joined by Diana Barb and Jay Shubrook in a discussion around effective therapies and strategies for fighting fatty liver disease that are available now. The group discusses frontline screening, medications, bariatric surgery, lifestyle management, practical insights and much more.

Co-hosts Ken Cusi and Roger Green are joined by Diana Barb and Jay Shubrook in a discussion around what tools are available today for fighting fatty liver disease. This is an entirely apt and applicable conversation that drills to the core of how important the role of frontline treaters is in putting a dent in an unraveling public health crisis.

Among a plethora of invaluable and practical insights, the following major themes emerge:

12:56 Primary Care Perspective: Why Screen Patients for Fatty Liver Disease?

Jay notes that when identified early, NAFLD and NASH are largely preventable and wholly treatable. Nevertheless, public awareness is low and patients are not typically presenting with questions around these conditions. He goes on to underscore the importance of adopting a leading and proactive role in screening, particularly for those with targeted risk factors like obesity, Type-2 diabetes and features of metabolic syndrome. When asked what proportion of his practice meets this criteria, Jay offers a sobering response: approximately half or two-thirds. Diana comments on the value of having a simple frontline screening tool, FIB-4, and elaborates in further detail on the goal of identifying those at most risk of fibrosis.

21:20 The Interplay of Endocrinology and Hepatology

Ken comments on the evolving relationship and dynamism between hepatologists working with endocrinologists to combat the swelling burden of NAFLD and NASH. His main note considers the ability to prescribe pioglitazone and GLP-1s as an adjunct to lifestyle interventions.

23:26 FIB-4 as a Predictor of Major Adverse Cardiovascular Events

Roger notes part of the utility of FIB-4 is its ability to identify patients with NAFLD at highest risk of cardiovascular events. Jay goes on to relate his on-ground experience of working with FIB-4 and assessing results to inform subsequent action.

25:11 Therapeutic Options: Now and the Future

Jay adds semaglutide to Ken’s note of pioglitazone and GLP-1s as therapeutic options available today useful to combat Fatty Liver disease. Jay suggests that he might continue using these drugs even after the approval of a NASH-specific drug. He states that simply, “we need to use the tools we have and we need to get comfortable with them.”

29:00 Patient Support and Lifestyle Management
The group considers how best to help patients implement and maintain healthy lifestyle habits. One important note that emerges is the need to adjust the barometer for which typically defines successful weight loss. Ken remarks that a 5% weight loss is a major success associated with less cardiovascular disease and diabetes.

39:54 Role of Bariatric Surgery

Roger asks for what considerations and motivations precede recommending bariatric surgery. Diana and Ken diver deeper into this evaluation process, noting both the challenges and efficacy of the treatment option not only for NASH, but also diabetes.

As the session winds down, the panelists return to analyzing the pharmacotherapy landscape before parting with practical tips for the listeners. If you enjoy the episode, have questions or interest around its contents, we kindly ask that you write us your questions.

This podcast series and all 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.

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