The fact that diabetes makes patients predisposed to other diseases is not something new. A recent nationwide study found a new health challenge that Type-2 diabetes patients face – hidden liver fibrosis.

According to the DiaFib-Liver Study, which studied over 9,000 adults with Type-2 diabetes from diverse regions in the country, found that one in four diabetics has hidden liver fibrosis. 

Published in The Lancet Regional Health – Southeast Asia, the study was conducted by a team of 48 physicians, diabetologists, and endocrinologists under the Diabetes and Liver Interest Group of Diabetes India. The study was conducted from January to July 2024. 

The study was led by Ashish Kumar, a gastroenterologist from Delhi.

“It is the largest real-world survey of liver fibrosis in diabetic patients ever conducted in a low- or middle-income country. Participants were drawn from routine diabetes care settings — not liver clinics — making the findings directly relevant to everyday clinical practice,” Faraz Farishta, Professor and Director of FS Endocrine and Diabetic Centres, told businessline.

“One in twenty already has probable cirrhosis – despite having no symptoms of liver disease.

About 26 per cent of patients (approximately 2,400) had clinically significant liver fibrosis. About   and 14 per cent had advanced fibrosis,” he said.

Fibrosis was present even in non-obese individuals and in those without fatty liver on imaging

“Obesity, dyslipidaemia, reduced kidney function, and longer duration of diabetes were independent risk factors,” he said.

Stating that the country is home to over 10 crore adults Type 2 diabetes, he said that diabetes care had historically focused on blood sugar control and complications such as retinopathy, neuropathy, and kidney disease.

“Liver disease has remained largely neglected due to its silent progression. The DiaFib-Liver Study demonstrates that liver fibrosis is at least as common as these established complications, yet it is almost never screened for,” Faraz, a metabolic physician, said.

The researchers suggested that liver disease should be recognised as a ‘fourth major complication’ of diabetes (after heart, brain and kidney) in the country. They said that non-invasive fibrosis assessment should be included in the routine diabetes care.

They felt that early detection through non-invasive tools such as FibroScan would help high-risk patients from developing serious complications such as liver failure.

“A timely detection and subsequent intervention could potentially prevent the condition progress into cirrhosis,” he said.

Published on March 27, 2026