By naturopath Margaret Jasinska
Did you know that type 2 diabetics are 50% more likely to develop liver disease? Particularly fatty liver disease.
Fatty liver disease is incredibly common in overweight people; nearly everyone with excess weight on their abdomen has some degree of fatty liver. Type 2 diabetics are prone to carrying excess weight on their abdomen, but even slim diabetics often have a fatty liver. This is because they are insulin resistant and their liver manufactures excess fat.
It is well known that diabetes increases the risk of kidney disease, nerve damage, blood vessel damage, infections, blindness, erectile problems and heart disease, but you may not realise diabetes has terrible effects on the liver. You can’t see or feel the effects it’s having on your liver until liver cells become damaged.
According to Gillian Booth, MD, MSc, of St. Michael’s Hospital in Toronto, in a population-based study, newly diagnosed diabetes was linked with a near doubling in the rate of cirrhosis, liver failure or liver transplant compared with non-diabetics. Clearly these are significant findings that should be taken seriously.
Insulin resistance (syndrome X) is the driving force behind the development of fatty liver. Insulin resistance is a forerunner to type 2 diabetes. If the insulin resistance becomes severe enough, a person usually develops type 2 diabetes. Type 1 diabetes usually develops in childhood, although by the time they are in their mid 30s, most type 1 diabetics have developed insulin resistance as well, and they face the same risks as type 2 diabetics when they get older.
People with insulin resistance have high levels of insulin in their bloodstream. Insulin signals to your liver to manufacture fat, especially triglycerides and cholesterol. This promotes the accumulation of fat inside the liver, inside other organs, inside arteries and as general body fat stores. As insulin levels become higher and higher, insulin loses its ability to control blood sugar. Therefore the blood sugar level creeps upwards, eventually getting high enough to qualify as diabetes.
Whenever you eat carbohydrate containing foods, your body digests them and breaks them down into simple sugars, including glucose. All foods contain some carbohydrate except animal protein such as meat, fish, poultry, eggs as well as pure fat like oil and lard. Glucose isn’t of much use to you in your bloodstream; you need it inside your cells where it can be used for energy. It is the job of insulin to transport the glucose from your bloodstream into your cells.
People with insulin resistance lose the ability to do that, therefore they crave foods high in carbohydrate (such as sugar, bread, pasta) and feel weak, hungry or irritable if they don’t eat these foods regularly. Because their body cannot use carbohydrate efficiently for energy, these carbohydrate rich foods are converted into fat instead. The vast majority of diabetics have a fatty liver. You do not need to be overweight to have a fatty liver; the condition is very common in slim people.
If you have diabetes, you are probably well aware that you require regular blood tests to check on the health of your kidneys and your heart. You probably have regular eye exams and foot examinations; however it is not standard practice to offer diabetics liver exams.
The authors of this study recommend that every diabetic has a blood test and ultrasound to check on the health of their liver annually. The blood test would check the levels of liver enzymes (to test for inflammation and damage to liver cells) and the ultrasound would check for the presence of fat accumulation. A CT scan and liver biopsy may be required in cases of advanced liver disease.