The Link Between Diabetes and Fatty Liver: All You Need Know

The Link Between Diabetes and Fatty Liver: All You Need Know
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The human body’s intricate physiological operations are like a well-conducted orchestra, with different organs playing crucial roles to maintain harmony and health. Among these, the liver, often referred to as the body’s chemical factory, plays a significant role in regulating our body’s blood sugar levels by working closely with insulin. However, the presence of excess fat can disrupt this fine-tuned system, paving the way to insulin resistance and potentially progressing to Type 2 diabetes.
Renowned diabetologist Dr. V Mohan, Chairman of Dr. Mohan’s Diabetes Specialities Centre in Chennai, has shed light on this critical connection. He explains that when hepatic (liver) fat is reduced, insulin action in the liver can improve and, in certain cases, even reverse diabetes.
A health condition that exemplifies this complex relationship is non-alcoholic fatty liver disease (NAFLD). Intriguingly, diabetes and NAFLD share a bidirectional relationship, implying that individuals with NAFLD are predisposed to developing Type 2 diabetes and vice versa.
So, how does a liver become fatty, and how does this lead to diabetes?
Excessive weight gain, particularly the kind leading to abdominal obesity, is a primary culprit. This condition is characterized by the buildup of fat in the intra-abdominal area, also referred to as visceral fat or deep subcutaneous fat. Such fat deposition isn’t limited to the abdominal area but extends to organs like the liver, pancreas, heart, and other ectopic regions. This process results in insulin resistance, a key factor contributing to Type 2 diabetes. Therefore, by reducing hepatic and pancreatic fat, it’s possible to reverse Type 2 diabetes.
Furthermore, the buildup of fat in the liver compromises its ability to regulate fasting glucose levels, placing additional strain on the pancreas and its beta cells, thereby accelerating the onset of Type 2 diabetes.
In recent years, advances in pharmaceuticals have brought new hope to patients struggling with NAFLD. Drugs like Metformin, pioglitazone, Vitamin E, SGLT 2 inhibitors like dapagliflozin and empagliflozin, and GLP 1 receptor analogues like semaglutide have shown promise in improving NAFLD conditions. Moreover, specific classes of drugs to address obesity and NAFLD are under clinical trials.
Despite these medical advancements, it’s crucial to remember that “an ounce of prevention is better than a pound of cure.” NAFLD, if caught in its early stages, can be reversed. Around 30 to 35 per cent of the Indian population is believed to have some form of NAFLD, but this prevalence can jump to an alarming 75 per cent among individuals with Type 2 diabetes. The figure is even higher, between 80 to 100 per cent, among those with both diabetes and obesity.
Therefore, for effective prevention and early detection, regular health checks that include liver function tests (LFT) and an ultrasound of the liver are recommended. If these reports aren’t normal, further investigations like a fibroscan or, in the case of suspected NASH (a severe form of NAFLD), a liver biopsy may be suggested.
In conclusion, while the connection between a fatty liver and diabetes is complex, it’s clear that a proactive approach towards maintaining a healthy weight, routine health checks, and early intervention can make a significant difference in managing and potentially reversing these conditions.

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