Introduction: The Fib-4 index (FIB4) is recommended for screening liver fibrosis (LF) risk in adults with T2D. Recent evidence suggests that dynamic changes (increases/decreases) in FIB4 overtime may be linked to subsequent risk of liver events and diabetes-related complications. We explored the change in FIB4 among adults with T2D engaged in a quality improvement initiative within primary care-the DIABEMPIC program.
Methods: This quasi-experimental, single group pre/post-intervention design encompassed participants undergoing a 5-month multicomponent comprehensive care program. Designed to improve diabetes care goals, the program featured therapeutic diabetes education and interdisciplinary care, emphasizing intensive lifestyle modification and treatment intensification. No liver fibrosis-modifying drugs were used.
Results: The observed prevalence of indeterminate/high risk (FIB4 ≥ 1.3; IHR) for LF was 27%. Baseline characteristics and changes (Δ) in participants, stratified by baseline LF risk status, are detailed in Table 1. The Δ in FIB4 in the overall participants was -0.11 ± 0.5 (p = 0.004), while in the IHR group the Δ observed was -0.5 ± 0.77 (p < 0.001). At follow-up, 35 subjects (46%) moved from the IHR to the low-risk status.
Conclusions: This study underscore that intensive comprehensive care schemes within adults with T2D can mitigate the risk of LF, as measured through FIB4.
R. Silva-Tinoco: None. A. Rivas-Alarcón: None. V. delaTorre-Saldaña: None. A. Galindez-Fuentes: None. E. Márquez-Guillén: None. F. Santos-López: None. D. Amaya: None. E. Castro: None. B. Munguía: None. N. López: None. E.B. Guzman-Olvera: None. T. Cuatecontzi-Xochitiotzi: None.
