Diabetes and Fatty Liver
Nonalcoholic fatty liver disease — NAFLD, for short — is the most typical chronic liver disease in America. Because of the liver’s central function in many body processes, fat in the liver can have a causal sequence, increasing the threats of developing both heart disease and type 2 diabetes.
Diabetes Type 2 and Liver Disease
The links in between NAFLD and type 2 are especially well documented. Eighty percent of individuals with diabetes have fat in the liver, states Kenneth Cusi, MD, FACP, FACE, an endocrinologist at the University of Florida in Gainesville.
Significantly, researchers are realizing that the connection is no coincidence. “When I remained in medical school, people believed obesity-related fat in the liver was an innocent onlooker,” Cusi says. “Now endocrinologists are beginning to realize this is a problem that strikes home.”
Research indicates that NAFLD might contribute to prediabetes and type 2 diabetes. Because the liver plays such an essential role in controling the body’s blood sugar, the accumulation of fat in the essential organ makes it more difficult to manage fasting glucose levels. It likewise makes the body more resistant to insulin, straining the pancreas and its beta cells and accelerating the arrival of type 2 diabetes. “When you get fatty liver, diabetes is more difficult to manage,” Cusi states.
Also read: Diabetes and High Cholesterol
Yet even though the majority of people with type 2 diabetes may have fatty livers, Cusi states the condition is typically undiagnosed, due to the fact that of a lack of awareness amongst some medical professionals and the hidden nature of the disease.
Weight problems is one indicator that the liver might be fatty, however NAFLD is extremely tough to detect, often eluding blood tests and physical examinations. The most reliable method to identify it is a liver biopsy, an invasive and pricey procedure. Other choices include MRI scans and ultrasound, a less precise but more affordable approach. Physical exams and blood tests might not yield any results at all: “A minority of patients have discomfort or tenderness, but for the vast majority it offers no symptoms,” Cusi says. “That’s why it’s so difficult for clinicians. Even [patients’] liver enzymes can be normal.”
So who gets fatty liver, and why? Research studies have shown that Latinos are more likely to have type 2 diabetes than the majority of other ethnic or racial groups, a finding that made Cusi wonder if there was a connect to NAFLD. “Because Hispanics get more type 2 diabetes, there was an idea that they get more fatty liver disease,” Cusi states. “Our hypothesis was that Hispanics would have worse insulin resistance and even worse liver disease.”
No basic tests can detect NAFLD, however liver function tests can help you to understand the health of your liver. Unusual LFTs may suggest the presence of fatty liver disease, and medical professionals can conduct other tests to eliminate liver issues. A scan of the liver may also expose the possibility of NAFLD.
To test his theory, Cusi registered 152 obese or overweight patients in a study funded by the American Diabetes Association. Ninety-six of them were Latinos and 56 of them non-Hispanic whites. There were likewise 10 normal-weight participants in the study, to function as a “control” group. Cusi anticipated a higher proportion of the obese or overweight Latinos in the research study to have fatty liver disease, defined as having more than 5.5 percent of the liver inhabited by fat.
The research study involved a variety of tests, including scans of the liver and glucose tolerance tests. “We determined tolerance — how they were making insulin, insulin sensitivity in the muscle and liver — and took measurements of the adipose [fat] tissues,” Cusi discusses.
As the results was available in, though, it turned out that ethnicity had little to do with fat in the liver. “When we did studies, we found [Latinos] weren’t really that various,” Cusi says. The most crucial single aspect seemed to be weight problems, and Latinos tend to have more problems with weight problems than other groups. “It’s not that Hispanics are doomed by genes; they simply have the tendency to have more weight problems,” Cusi says.
See also: Diabetes Effects on Your Body’s Systems
Was the experiment a failure? Certainly not, states Cusi: “Our hypothesis was wrong, however we learned that the primary aspect is weight problems. That’s crucial, since we can do something about it,” Cusi says. “If there’s fat in your liver, think extremely seriously about lifestyle changes, and talk with your doctor about whether vitamin E supplements or pioglitazone [Actos] is right for you,” he adds, keeping in mind that pioglitazone is authorized only for patients with type 2 diabetes.
The secret to reversing the course of fatty liver disease is weight reduction. “Reduce carbs, and that decreases fat in the liver really quickly,” Cusi says. A loss of 5 percent of body weight suffices to start lowering liver fat, and just a few percentage points more start minimizing the swelling that is so closely connected to insulin resistance. “If you begin dropping weight,” Cusi says, “a lot of things get better.”
