Non-Alcoholic Fatty Liver Disease Among Newly Diagnosed Type 2 Diabetes Mellitus in North Bihar and Missed Opportunities for Early Diagnosis

Background: There are no studies investigating missed opportunities for earlier diagnosis in newly/recently detected Type 2 Diabetes Mellitus and Non-alcoholic Fatty Liver Disease in the region of Bihar, India.

Methods: This study is a single-center cross-sectional study undertaken at the Research Centre for Diabetes Hypertension and Obesity, Samastipur, Bihar, India. The study collected data from newly/recently diagnosed persons with T2DM. The study was conducted between December 2022 and May 2023.

Results: A total of 148 people with newly diagnosed T2DM were included (median age 47, 46.6% female), and 109 patients with liver disease on ultrasound evaluation. The majority of the persons detected with diabetes were symptomatic. The commonest group of typical symptoms were excessive hunger, urinary frequency, excessive thirst, and evening fatigue, which were present in 46 individuals with liver disease. The best pathway includes a group of persons who visited specialists and MBBS doctors once they felt their symptoms should be evaluated by them and diagnosed within two months of their symptom onset. Unfavorable pathways causing delays in diagnosis and hindering efficient care involve individuals with diabetes seeking help from village doctors, pharmacists, and Aayush doctors, thereby contributing to missed opportunities.

Conclusion: NAFLD is prevalent in new T2DM, especially among those with high fat intake and obesity markers. This study could initiate future research aiming to improve NAFLD management and decrease associated complications in newly diagnosed persons with T2DM.