The Growing Trend of Diabetes Tied to Liver Disease

It seems that when the average person thinks of liver disease, they assume it is the direct result of alcohol abuse. The most common form of chronic liver disease is Non-Alcoholic Fatty Liver Disease (NAFLD), which affects an estimated 80 to 100 million Americans.[i]  Thus, it's not the alcohol abuse, but type 2 diabetes that is our most significant risk for liver failure.

The insulin resistance that is the primary cause of type 2 diabetes is linked to the fatty liver development that can lead to NAFLD and a host of other serious afflictions.

iStock-884520894 liver disease in obesityWhile the association between patients with type 2 diabetes having (NAFLD) has been known to be quite common, recent studies indicate that obesity and type 2 diabetes have skyrocketed to 80-90% of NAFLD cases.[ii] 

This trend would appear to make sense since researchers predicted back in early 2016 that hospital admissions and deaths caused by liver disease would rise if the cases of type 2 diabetes continued to increase at current rates.[iii]

The link between diabetes and liver disease is like a vicious cycle, as NAFLD increases the risk of type 2 for those who do not have diabetes. If you do not have diabetes, focusing on your liver health should be a priority because fatty liver disease can cause type 2 diabetes.

These same studies also discovered that most cases of liver disease in people with type 2 diabetes were not alcohol-related but the direct result of fat build-up within the liver cells.[iv]

NAFLD, like all liver diseases, should be taken seriously because having this diagnosis will significantly increase the risk of life-threatening complications like cirrhosis and liver cancer. What's more, the treatment options for NAFLD are somewhat limited and costly.

Also, men with type 2 diabetes were three times more likely to develop NAFLD and other liver diseases than men without; and while there were fewer cases of women with type 2 diabetes and liver disease, just having diabetes raises the risk of NAFLD by five times.

To further underscore my point, a 2018 study of patients with both type 2 diabetes and NAFLD revealed that more than half developed a more severe form of liver disease known as non-alcoholic steatohepatitis (NASH).[v] It is the painful inflammation and scarring from NASH that can lead to liver failure.

iStock-1010641210 human liver anatomyManaging your type 2 diabetes can significantly minimize your risk of developing NAFLD.

There is a prevalence of NAFLD among patients who suffer from hyperglycemia, which is an excess of glucose in the bloodstream.[vi] To me, hyperglycemia is a fancy word for uncontrolled diabetes.

Patients with type 2 diabetes, especially the recently diagnosed, should get early screening for hyperglycemia. ALL PATIENTS should stay dedicated to managing their diabetes using the program they established with their care management team. 

When you consider the survival rate for liver cancer is 31% at best (and that is only with early-stage diagnosis),[vii] and the quality of life with cirrhosis probably feels like a death sentence (in spite of the odds of survival being higher), why wouldn’t you do all that you could to properly manage your type 2 diabetes?

Defense Tactics Against NAFLD 

  • Monitor and control your blood sugar levels. Work closely with your care management team to maximize your chances for success.
  • Maintain a healthy weight or lose weight if you need to with regular exercise and a healthy diet.
  • Limit your LDL or "bad" cholesterol consumption. Simply put, replace the chips, fries, and other salty snacks, as well as the rice and potatoes, with nuts, avocados, cottage cheese, quinoa, and whole grains (all great HDL "good" cholesterol options).
  • Do not drink alcohol regularly. Save the occasional drink for holidays and special occasions.
  • Ask your doctor for an ultrasound examination of your liver, as well as regular follow-up blood tests to track your liver function.

There are no "secret tips" to fatty liver disease prevention, other than managing your blood sugar and biting the bullet on improving your diet and exercise. The good news is that if you can select foods that fight cell damage and make it easier for your body to use insulin, you can prevent or even reverse a NAFLD condition.[viii] 

You will find these types of foods in a Mediterranean Diet, which consists of healthy fats, antioxidants and complex carbohydrates that help cut out fat from your liver. Fish, fruits, nuts, whole grains, olive oil, and vegetables are the superstars of this diet, and they are all accessible and relatively affordable. 

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[i] https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567
[ii]https://www.researchgate.net/publication/316957386_Prevalence_of_Non_Alcoholic_Fatty_Liver_Disease_and_its_Association_with_Diabetic_Nephropathy_in_Patients_with_Type_2_Diabetes_Mellitus 
[iii] https://www.sciencedaily.com/releases/2016/04/160412110746.htm
[iv] https://www.sciencedaily.com/releases/2016/04/160412110746.htm
[v] https://www.endocrineweb.com/professional/type-2-diabetes/half-patients-type-2-diabetes-have-nonalcoholic-fatty-liver-disease-rec
[vi] https://www.endocrineweb.com/professional/type-2-diabetes/half-patients-type-2-diabetes-have-nonalcoholic-fatty-liver-disease-rec
[vii] https://www.cancer.net/cancer-types/liver-cancer/statistics
[viii] https://www.webmd.com/hepatitis/fatty-liver-disease-diet#1

Sean Browne

Sean Browne

Chief Revenue Officer, CCS Medical

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