Fig. 5.

Evaluation of non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM). All adults with T2DM should be evaluated for the presence of NAFLD. Liver function tests or abdominal ultrasound should be performed to evaluate NAFLD and to exclude secondary causes. Non-invasive and simple tests, such as the fibrosis index-4 (FIB-4) or the NAFLD fibrosis score (NFS), can be used to evaluate liver fibrosis. Vibration-controlled transient elastography should be considered when evaluating liver fibrosis in T2DM adults, excluding those in low-risk groups. ^aLow risk: FIB-4 <1.3, NFS <2.67, ^bLow risk: liver stiffness measurement <8.0 kPa, Enhanced Liver Fibrosis (ELF) score <10.5.