A Frequent Pair: Type 2 Diabetes And Fatty Liver Disease

All human beings can protect their liver and show it appreciation by eating well, getting regular exercise, and maintaining a healthy weight.

However, this is especially important for people with type 2 diabetes since they are prone to a harmful buildup of fat in their liver called non-alcoholic fatty liver disease, NAFLD for short.

Statistics indicate at least 50 percent of those with type 2 diabetes will develop this condition.

Too Much Of A Good Thing

Though too much fat in the body is a problem, fat is not inherently bad. All organs contain some protective fat cells, and normal livers are about a five percent fat.

If the fat in our liver exceeds 10 percent, then fat cells begin to replace healthy liver cells. This early stage of NAFLD, called steatosis, does not generate noticeable symptoms and may not cause serious problems. However, if the fat continues to build, our risk for heart disease, stroke, liver cancer, and liver failure increases.

Fortunately, basic healthy living habits work well to keep NAFLD from either developing, or progressing to the point of severe liver damage. Good habits may also reduce any amount of excess fat already in the liver.

The Fat Handler

Though too much fat can harm it, our humble appearing liver is a powerful fat processing center. It produces fat, exports it to tissues throughout the body, and removes fats from our bloodstream, including those we eat. This process is disrupted when:

  1. An increased amount of fat is removed from the blood or made by the liver cells, and
  2. Not enough fat gets exported.

Like any exporter that can’t move its goods, the liver begins to stockpile its product when a lot is coming in, and very little is going out.

Over time, as fat accumulates, inflammation sets in and can damage liver cells. Eventually, if the inflammation continues unabated, liver cells begin to die and cirrhosis - a fibrous thickening of the liver tissue - may develop.

NAFLD Risk Factors

NAFLD is not just a growing issue in the U.S., it is the most widespread type of liver disease in developed countries. While not having a specific cause, the condition is often associated with:

  • Insulin resistance.
  • Having pre-diabetes, or type 2 diabetes. (It’s not clear whether NAFLD occurs more frequently in people with type 1 diabetes than in the general population.)
  • Being overweight, or obese.
  • Elevated triglycerides, cholesterol, and/or blood pressure.
  • Sleep apnea, and polycystic ovary syndrome.

?NAFLD is also more common in men, and older folks.

Protective Habits

It may be that NAFLD plays a role in the development of type 2 diabetes, but once someone has both conditions, poorly controlled glucose levels can worsen the fatty liver disease.

Happily, many of the same habits that constitute good diabetes management also defend against NAFLD, for instance:

  • Gradually losing just five to ten percent of our weight, if recommended, can reduce fat buildup, liver cell damage, and inflammation.
  • Regular exercise prevents and treats NAFLD by promoting weight loss or maintenance, improving insulin sensitivity, and glucose control, and reducing the chances for cardiovascular disease.
  • A diet of fresh, whole foods including plenty of veggies and healthy fats (e.g., nuts, olive oil, avocado) is good for our glucose, heart, and liver. It’s especially important to get adequate amounts of omega-3s, vitamin E, and vitamin D either via our diet, or through supplementation.

Naturally, it’s also advantageous to take our diabetes medications as prescribed, and though NAFLD isn’t caused by alcohol, limiting our intake is recommended.

Sources: Fatty-Liver; Amy Campbell/Diabetes Self Management; Medicine Net; Mayo Clinic
Photo credit: Michael Johnson

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