1986-LB: Feasibility and Acceptability of an Intervention to Improve Metabolic Liver Disease in Latino/a and Black Patients with Diabetes

Patients with type 2 diabetes (T2D), and particularly those from historically marginalized racial/ethnic groups, are at high risk of poor outcomes from metabolic dysfunction-associated steatotic liver disease (MASLD). In this 3-month feasibility pilot, we proactively delivered evidence-based care for MASLD in Latino/a and/or Black patients with T2D and elevated liver enzymes, with a goal of reducing risk of MASLD progression. We recruited 10 patients (5 Latino/a and 5 Black) with T2D and alanine aminotransferase level (ALT) >40 U/L; exclusions for non-MASLD liver disease were applied. The intervention was entirely remote and included: a) MASLD education; b) monthly diet/lifestyle counseling sessions; c) T2D medication management, with prioritization of glucagon-like peptide-1 receptor agonists and pioglitazone as appropriate; and d) clinically-indicated ordering of liver tests and referrals. Primary outcomes were feasibility and acceptability as measured by the Treatment Acceptability and Preferences (TAP) measure and participant interviews. Mean patient age was 51.1 (SD 9.6) and 5/10 participants were female. Mean BMI was 36 (SD 5.6), HbA1c was 6.9% (SD 1.2) and ALT was 58 U/L (SD 17.6). At 3 months, retention rate was 100% and all 30 study visits were completed. Mean TAP was 3.98 (SD 0.13) with a maximum score of 4, indicating high intervention acceptability. All participants felt the intervention was helpful in improving their awareness of MASLD and motivating behavioral change to reduce MASLD risk. Of the 10 participants, 5 had their T2D medications adjusted, 2 underwent liver ultrasound (both had steatosis) and 1 was referred to Hepatology. This study demonstrates feasibility and acceptability of an intervention that delivers evidence-based care for MASLD in Latino/a and Black patients with T2D.