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Recent studies show that patients with diabetes and prediabetes have a significantly higher prevalence of advanced liver fibrosis than previously recognized, with rates in primary care populations ranging from 9% to 15%.[4][5][6] The Fibrosis-4 (FIB-4) score is validated as the most accurate and accessible first-line tool for risk stratification in these groups, outperforming other non-invasive markers in identifying low-risk patients who can be safely managed in primary care and guiding when to refer patients to hepatology.[7][4][8][9] Systematic FIB-4 screening enables early detection and appropriate triage, helping prevent progression to cirrhosis and liver-related complications Why is FIB-4 screening important