Diabetes & Liver Health: What´s The Link?

Diabetes as a risk factor

Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia (high blood sugar levels).

Diabetes which affects over 29 million in the U.S. alone is considered one of the major risk factors of non-alcoholic fatty liver disease (NAFLD), and subsequently – more severe hepatic fibrosis, cirrhosis, and even end-stage liver disease*.

But how can we explain this strong link between diabetes and liver disease?

98% of Liver Experts Would Recommend Amsety Bars

How is diabetes associated with liver disease?

The association between these two disorders is scientifically well established and is classified in three categories*:

• Liver disease developing due to diabetes
• Hepatogenous diabetes (HD)
• Liver disease occurring coincidentally with diabetes mellitus

Fully developed and long-lasting type 2 diabetes can trigger a whole set of mechanisms that consequently contribute to the developing or worsening of liver disease. These mechanisms include insulin resistance, iron overload, oxidative stress, steatosis, hepatic fibrosis, inflammation, and even bacterial infections.

Obesity as a common co-risk factor of diabetes and liver disease can also be attributed to this strong connection between these two diseases.

The association between diabetes and liver disease is reciprocal – patients with type 2 diabetes are at high risk of developing a liver disease such as NASH, fibrosis, cirrhosis, and even liver cancer and patients with liver disease are at risk of type 2 diabetes.

*Sources:

Hamed AE, Elsahar M, Elwan NM, El-Nakeep S, Naguib M, Soliman HH, Ahmed Aboubakr A, AbdelMaqsod A, Sedrak H, Assaad SN, Elwakil R, Esmat G, Salh S, Mostafa T, Mogawer S, Sadek SE, Saber MM, Ezelarab H, Mahmoud AA, Sultan S, El Kassas M, Kamal E, ElSayed NM, Moussa S. Managing diabetes and liver disease association. Arab J Gastroenterol. 2018 Dec;19(4):166-179. doi: 10.1016/j.ajg.2018.08.003. Epub 2018 Nov 9. PMID: 30420265.

P. Angulo, J. C. Keach, K. P. Batts, and K. D. Lindor, “Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis,” Hepatology, vol. 30, no. 6, pp. 1356–1362, 1999.

Y. Arase, M. Kobayashi, F. Suzuki et al., “Effect of type 2 diabetes on risk for malignancies includes hepatocellular carcinoma in chronic hepatitis C,” Hepatology, vol. 57, no. 3, pp. 964–973, 2013.

Loria P, Lonardo A, Anania F. Liver and diabetes. A vicious circle. Hepatol Res. 2013;43(1):51-64. doi:10.1111/j.1872-034X.2012.01031.

de Marco R, Locatelli F, Zoppini G, Verlato G, Bonora E, Muggeo M: Cause-specific mortality in type 2 diabetes: The Verona Diabetes Study. Diabetes Care 22:756–761, 1999.