Lomonaco R, Leiva EG, Bril F, et al. - Unselected patients with type 2 diabetes mellitus (T2DM) were assessed for the prevalence of nonalcoholic fatty liver disease (NAFLD) and of liver fibrosis associated with nonalcoholic steatohepatitis. Among a total of 561 patients with T2DM (age: 60 ± 11 years; BMI: 33.4 ± 6.2 kg/m2; and HbA1c: 7.5 ± 1.8%) who were attending primary care or endocrinology outpatient clinics and were not aware they had NAFLD, screening revealed steatosis in 70% and fibrosis in 21% (LSM ≥7.0 kPa) of these patients. Overall findings suggest that at least one out of six (15%) patients with T2DM exhibits moderate-to-advanced fibrosis (F2 or higher), which is an established risk factor for cirrhosis and overall mortality. The American Diabetes Association guidelines that suggest screening for clinically significant fibrosis in patients with T2DM with steatosis or elevated ALT are supported by these results.