Embedding assessment of liver fibrosis into routine diabetic review in primary care

•People with type 2 diabetes are at increased risk of advanced liver fibrosis, exacerbated by excess alcohol consumption.•Incorporating a 2-step fibrosis assessment into primary care diabetes review increased advanced fibrosis detection 7-fold.•Fib-4 scores automatically calculated at diabetic review in primary care and results displayed with advisory comments.•Almost half the patients identified with advanced liver disease had alanine transferase below the laboratory cut-off.•This pathway could improve detection of advanced liver disease in individuals with type 2 diabetes in primary care.