Press release

American Diabetes Association Releases a Guideline Update in NAFLD (Non-Alcoholic Fatty Liver Disease) and Diabetes

June 25, 2023 | Arlington, Virginia

New guidelines include recommendations for the detection and management of nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) in people with diabetes

Today, the American Diabetes Association® (ADA) published updates in the Standards of Care in Diabetes—2023 (Standards of Care) based on the latest scientific research and clinical trials.

Liver disease affects up to 70% of people with type 2 diabetes. Nonalcoholic fatty liver disease (NAFLD), which includes nonalcoholic steatohepatitis (NASH), is the most common form of liver disease in people with diabetes. NAFLD can lead to cirrhosis and liver cancer and is associated with an increased risk of cardiovascular disease and death.

Section 4, “Comprehensive Medical Evaluation and Assessment of Comorbidities,” of the Standards of Care has been updated to include several new recommendations regarding screening and treatment of NAFLD/NASH in individuals with diabetes.

“Liver disease is increasingly being recognized as a major complication of diabetes,” said Dr. Robert Gabbay, Chief Scientific and Medical officer at the ADA. “ADA is committed to preventing and curing diabetes, a complex, chronic illness that requires continuous medical care. For more than 30 years, ADA has been actively involved in the development of clinical practice recommendations that clinicians, researchers, health plans, policymakers, and others can rely on to guide diabetes care.”

“Diabetes and liver disease are closely linked, and it is essential that healthcare professionals have the most current information to effectively detect and manage this disease,” said Nuha ElSayed, MD MM Sc, the overseer of the ADA standards of care guidelines and chair of the professional practice committee.

This update emphasizes the importance of early detection of NAFLD in people with diabetes as well as appropriate management modalities. Early detection allows for timely treatment, reducing the chance of developing other serious complications.

The Standards of Care is reviewed and updated by the ADA’s Professional Practice Committee (PPC). The committee is a multidisciplinary team of leading U.S. experts in the field of diabetes care and includes physicians, nurse practitioners, diabetes care and education specialists, registered dietitians, pharmacists, methodologists, and others with experience in adult and pediatric endocrinology, epidemiology, public health, cardiovascular risk management, microvascular complications, preconception and pregnancy care, weight management, diabetes prevention, behavioral and mental health, inpatient care, and use of technology in diabetes management.

The Standards of Care in Diabetes—2023 is freely accessible online and is published as a supplement to the January 2023 issue of Diabetes Care®. The online version is updated when new evidence or regulatory changes merit immediate incorporation through the “Living” Standards of Care process. The ADA fosters broad dissemination through a shortened version of the guidelines, known as the Abridged Standards of Care, for primary care providers in its journal Clinical Diabetes® and offers a convenient Standards of Care app as well as a Standards of Care pocket chart. Other resources, including a webcast with continuing education credit and a full slide deck, can be found on the ADA’s professional website, DiabetesPro®.



About the American Diabetes Association
The American Diabetes Association (ADA) is the nation’s leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For 82 years, the ADA has driven discovery and research to treat, manage, and prevent diabetes while working relentlessly for a cure. Through advocacy, program development, and education we aim to improve the quality of life for the over 133 million Americans living with diabetes or prediabetes. Diabetes has brought us together. What we do next will make us Connected for Life®. To learn more or to get involved, visit us at or call 1-800-DIABETES (1-800-342-2383). Join the fight with us on Facebook (American Diabetes Association), Spanish Facebook (Asociación Americana de la Diabetes), LinkedIn (American Diabetes Association), Twitter (@AmDiabetesAssn), and Instagram (@AmDiabetesAssn).