29-OR: Analysis of Fib-4 Index Changes in Adults with Type 2 Diabetes in an Effective Comprehensive Diabetes Care Program

• Published in: Diabetes (New York, N.Y.) Vol. 73; no. Supplement_1; p. 1
• Main Authors: SILVA-TINOCO, RUBÉN, RIVAS-ALARCÓN, ALINNE, DELATORRE-SALDAÑA, VIRIDIANA, GALINDEZ-FUENTES, ANA, MÁRQUEZ-GUILLÉN, ERNESTO, SANTOS-LÓPEZ, FRANCISCO, AMAYA, DAVID, CASTRO, ELIZABETH, MUNGUÍA, BERENICE, LÓPEZ, NARAI, GUZMAN-OLVERA, EILEEN B., CUATECONTZI-XOCHITIOTZI, TERESA
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 14.06.2024
• Subjects: Diabetes; Diabetes mellitus (non-insulin dependent); Fibrosis; Liver; Liver cirrhosis; Primary care; Quality control
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/db24-29-OR

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.