A NUTRITION-FOCUSED telemedicine model may significantly reduce the risk of metabolic dysfunction-associated steatotic liver disease (MASLD) in adults with type 2 diabetes and obesity, according to new real-world data.
MASLD, a condition characterised by excess fat accumulation in the liver linked to metabolic dysfunction, can progress to metabolic dysfunction-associated steatohepatitis (MASH), contributing to substantial morbidity and mortality.
Why MASLD Matters in Metabolic Disease
MASLD and its progressive forms are increasingly recognised as major complications of type 2 diabetes and obesity. As prevalence rises globally, scalable interventions that address underlying metabolic drivers, such as diet, are of growing clinical interest. However, evidence for digitally delivered, nutrition-led care models in preventing liver disease progression has remained limited.
Telemedicine Nutrition Model Linked to Lower MASLD Incidence
The study evaluated an individualised, carbohydrate-reduction-focused telemedicine programme (Virta Individualised Nutrition Therapy, VINT) using data from the Komodo Healthcare Map between 2015 and 2024. A total of 5,031 adults with type 2 diabetes, prediabetes, overweight or obesity enrolled in VINT and were matched 1:1 with usual care controls.
Across three analytic approaches, VINT participation was consistently associated with lower rates of liver-related outcomes. Incidence of any liver diagnosis was 29.9 per 1,000 person-years in the intervention group versus 44.9 in controls. Patients in the telemedicine group has a 36% lower risk of developing liver disease at any given time compared with usual care.
For more advanced disease, including MASH, participants in the intervention group had a 62% lower risk of progression at any given time. The risk of developing advanced liver disease was reduced by 67%, while liver-related complications were reduced by 75% compared with controls.
Weight Loss Strengthens Reduction of MASLD Risk
Within the intervention group, outcomes appeared to improve further with greater weight loss. Participants who achieved at least 15% weight reduction had a 34% lower risk of developing liver disease over time compared with those who lost less weight.
Implications for MASLD Care in Adults with Type 2 Diabetes
These findings support a lifestyle-first approach to managing MASLD risk in high-risk populations. For clinicians, the results suggest that a structured, telemedicine-delivered nutrition intervention focused on carbohydrate reduction and sustained weight loss may offer a scalable strategy to reduce liver disease burden in adults with type 2 diabetes and obesity.
Telemedicine programmes may also improve access to care for patients in rural or underserved areas, where in-person specialised nutrition services are limited. Although the study was observational and cannot establish causation, the consistent risk reductions across multiple liver-related outcomes highlight the potential real-world impact of targeted nutritional telemedicine programmes. Future analyses incorporating additional measures, such as waist circumference, body composition, or other anthropometric data, could provide further insight into how changes in body fat distribution and metabolic health influence liver disease risk.
Reference
Shaminie A et al. Reduced risk of liver related events among patients receiving individualized nutrition-focused remote care in the united states. Hepatology. 2026;DOI:10.1097/HEP.0000000000001713.
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