PD337 - EFFECTS OF DIETARY INTERVENTIONS ON LIVER HEALTH IN PEOPLE WITH TYPE 2 DIABETES: A SYSTEMATIC REVIEW

PD337

EFFECTS OF DIETARY INTERVENTIONS ON LIVER HEALTH IN PEOPLE WITH TYPE 2 DIABETES: A SYSTEMATIC REVIEW

C. A. Dietvorst^1,2,*, L. A. Konings^1,2, J. P. Uriza-Pinzón^3,4, J. Massoels⁵, A. G. Holleboom⁶, G. V. Dedoussis⁷, D. E. Grobbee^4,8, M. E. Tushuizen⁹, R. P. Peeters², K. A. Berk², M. Castro Cabezas^1,2,8

¹Internal Medicine, Franciscus, ²Internal Medicine, Erasmus MC, Rotterdam, ³Global Public Health & Bioethics, UMC Utrecht, ⁴Julius Centre for Health Sciences and Primary Care, Utrecht, Netherlands, ⁵Echosens SA, Paris, France, ⁶Vascular Medicine, Amsterdam University Medical Centre, Amsterdam, Netherlands, ⁷Nutrition and Dietetics, School of Health and Education, Harokopio University of Athens, Athens, Greece, ⁸Julius Clinical, Zeist, ⁹Gastroenterology and Hepatology, Leids University Medical Centre, Leiden, Netherlands

Rationale: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is highly prevalent in people with type 2 diabetes (T2D), yet current guidelines insufficiently address the potential benefits of dietary patterns for liver health. This review synthesises the evidence on the effects of dietary interventions on liver outcomes in individuals with T2D.

Methods: This systematic review followed PRISMA and Cochrane guidelines. A search of MEDLINE, Embase, the Cochrane Library, Web of Science and Google Scholar (to March 2026) identified studies assessing dietary interventions on liver outcomes in adults with T2D. Randomised controlled trials (RCTs) and single‑arm studies were eligible. Primary outcomes were reductions in liver steatosis or fibrosis assessed by imaging or biopsy; secondary outcomes included liver enzymes and non-invasive liver tests. Data extraction used standardised templates, and study quality was assessed using RoB2 (RCTs) and ROBINS‑I (non‑randomised studies).

Results: Across 47 studies (2729 participants), most dietary interventions reduced hepatic fat and improved liver enzymes, while effects on fibrosis were less studied. Energy-restricted (n=14) and low-carbohydrate diets (n=14) were most extensively investigated. Energy-restricted diets and intermittent fasting (n=8) showed the most consistent reductions in liver steatosis, whereas low-carbohydrate and Mediterranean diets (n=4) led to modest and more variable improvements.

Conclusion: Dietary interventions in individuals with T2D improve liver health, with energy‑restricted diets and intermittent fasting showing the most consistent benefits, especially on liver steatosis. Long‑term, high‑quality studies are needed to determine the durability of dietary effects on liver outcomes in people with T2D.

Disclosure of Interest: None declared