On Thursday, May 28th, EASL and EASD held a joint session co-chaired by Prof. Dídac Mauricio, University of Vic - Central University of Catalonia, and Prof. Frank Tacke, Charité Berlin. Dedicated to a rapidly growing challenge in metabolic medicine, panel members discussed the identification and management of people with type 2 diabetes who have metabolic dysfunction-associated steatohepatitis (MASH).
For addressing MASLD and MASH, we have to bring together not only hepatologists – this is not only a liver complication, this is a metabolic complication. And the message is that anyone involved in the care of metabolic conditions like type 2 diabetes and obesity should be there sharing views, expertise, and, of course, future pathways on how to tackle this problem that is really increasing. I am Dídac Mauricio. I’m an endocrinologist and diabetologist from the Department of Endocrinology and Nutrition in the Hospital de la Santa Creu i Sant Pau here in Barcelona. This is one of the major hospitals in the city. And I’m also a professor of endocrinology, and my main research area in the past few years has been all the clinical aspects of diabetes management, but especially diabetes and its complications. And over recent years our group has been become increasingly involved in research, clinical research mainly, on the metabolic dysfunction-associated steatotic liver disease. So we are running currently a clinic on MASH at our place. Actually, the session took place on Thursday, May 28th, here in Barcelona at the EASL Congress this year in the late afternoon. I think this session was really very welcome among the attendees, and I had the privilege to share the session with Professor Frank Tacke who is a well-known hepatologist, and he was the first author of the joint guidelines for MASLD management that were issued in 2024. He’s a hepatologist from the Charité Hospital in University Hospital in Berlin. And we had a very interactive session, and this was a very interesting initiative, because I think that endocrinologists, diabetologists and also GPs, there were not any GPs, because this was a very specialised meeting, but GPs would be also on board in discussing what are the main clinical pathways and issues in the care of patients with MASH and type 2 diabetes. Professor Tacke and myself were asked by the organisation to have several main questions to drive the discussion, and there were three main parts. The first part was on screening and case-finding, which is very important nowadays. Second, the diagnostic pathway, because there are still many open questions on this matter. And also treatment, because now we have some treatment strategies, not only lifestyle measures, which are very important, but also new drugs coming into the stage. That’s a possibility for patients to be treated for this condition. I think these were the main clinical issues now sharing both the hepatologists but also the endocrinologists and other professionals, like primary care professionals. The awareness on MASLD and MASH is still very low. There is ample room for improving that, and we need to have that implemented both in diabetes clinics in general, in metabolic clinics, obesity clinics, but also very importantly at the primary care level. And we should stress that people with type 2 diabetes are the group with a higher risk of MASLD and MASH. And finally, I would insist on the fact that we need a multidisciplinary and multifactorial approach which are the best strategies for addressing MASLD and MASH. This was a hepatology meeting, and there were a few endocrinologists on site. So that was very encouraging. So that means that the awareness among endocrinologists and diabetologists is increasing. But I think we have to bring together not only hepatologists. This is not only a liver complication. This is a metabolic complication. And the message is that anyone involved in the care of metabolic conditions like type 2 diabetes and obesity should be there sharing views, expertise, and, of course, future pathways on how to tackle this problem that is really increasing.
Video transcript
A central question was whether people with type 2 diabetes should be universally screened for MASLD and MASH, or whether screening should be stratified according to individual risk. Prof. Mauricio describes the joint session as an important opportunity to bring hepatology and diabetes care closer together and emphasises that practical implementation of screening remains challenging as resources vary widely across healthcare settings.
Another key question was whether more precise tests, such as FibroScan and ELF test, should be used earlier or even directly in diabetes care pathways. Mauricio summarises: “We are far from their implementation, because of a lack of resources. So, the practical conclusion of our discussion was that referral pathways between diabetology, primary care and hepatology need to be adapted to local structures, available resources and the organisation of hospital and primary care settings.”
Regarding treatment, Mauricio notes that the emergence of new pharmacological options is reshaping the clinical discussion around MASH. This shift has prompted an update to the 2024 EASL-EASD-EASO Clinical Practice Guidelines on MASLD, which Prof. Tacke announced will be published later this year. However, Mauricio emphasises that despite the growing role of these new therapies, lifestyle intervention remains the cornerstone of MASH management.
The broader metabolic risk profile of people with MASH must also be considered. “These patients do not only have liver diseases. They often have obesity-related complications and increased cardiovascular risk in addition,” says Mauricio. “So in the end, we need a multidisciplinary collaboration including hepatologists, diabetologists, general practitioners, and probably further healthcare professionals like nurses, nutritionists, and dietitians.”
EASL Congress 2026, Barcelona, Spain
EASL/EASD Joint Session “Multidisciplinary interactions to identify type 2 diabetes patients with fibrotic MASH eligible for anti-MASH therapy”
Chairs: Dídac Mauricio (Spain), Frank Tacke (Germany)