Subject: Survey to understand knowledge & approach of consulting physicians towards managing NAFLD in diabetes in India
Non-alcoholic fatty liver disease (NAFLD) is defined as the presence of hepatic steatosis in the absence of secondary causes. It is emerging as a public health issue worldwide, with a global pooled prevalence, of 25.24% among general population. NAFLD includes a spectrum of diseases ranging from simple steatosis to non-alcoholic steatohepatitis (NASH), and to advanced fibrosis and cirrhosis and hepatocellular carcinoma, causing considerable liver-related morbidity and mortality. Evidence indicate that NAFLD could be regarded as a hepatic manifestation of metabolic syndrome associated with metabolic risk factors such as obesity, diabetes mellitus, and dyslipidaemia. Epidemiological studies suggest the prevalence of NAFLD to be around 9-32% in general Indian population, with a higher incidence amongst overweight/obese and diabetic/ prediabetic patients.
The association between NAFLD and type 2 diabetes mellitus (T2DM) has been well established. Compared with nondiabetic subjects, patients with T2DM appear to have an increased risk of developing NAFLD and certainly have a heightened risk of developing advanced liver diseases, such as fibrosis, cirrhosis, and hepatocellular carcinoma. NAFLD in T2DM may lead to a higher risk of developing cardiovascular disease and diabetic vascular complications, independently of other known risk factors. The prevalence of NAFLD in T2DM patients in India is reported to be in range of 12.5-87.5%.
As the prevalence of NAFLD in diabetics is substantial, consulting physician plays an important role in management of NAFLD metabolic risks. Diabetics must be monitored for NAFLD/NASH with a vigilant eye, similar to the way the other complications of diabetes, like retinopathy and nephropathy. A knowledge of preventive measures and available treatment is needed in order to manage the milder disease forms at primary care level.
There is limited data available on physician’s knowledge & approach towards managing NAFLD in diabetes. Therefore, this cross-sectional study is designed to understand knowledge & approach of consulting physicians towards managing NAFLD in diabetes in India.
If you agree to participate, you will need to provide assessment response, on to the standard data collection form (which we call DCF). A monitor will assist you in verifying and collecting the DCF.
We trust you and we are partners in promoting safe and effective drug therapy. In that spirit we hope you will consent to participate in this study. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records.
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