Diabetes & Liver Disease

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For the purpose of the study, researchers from St. Michael's Hospital, University of Toronto and the Institute for Clinical Evaluative Sciences in Toronto used administrative health databases for the province of Ontario from 1994 to 2006 and population based matched retrospective cohort study was conducted on 2,497,777 adults aged 30 to 75 years.

The exposed group comprised 438,069 adults with newly diagnosed diabetes.

The unexposed comparison group, those without known diabetes, consisted of 2,059,708 individuals. Each diabetic individual (exposed group) was matched to five randomly selected individuals without a diagnosis of diabetes (from unexposed comparison group) by year of birth, sex and local health region.

Persons with preexisting liver or alcohol-related disease were excluded. The main study endpoint was incident serious liver disease, defined as cirrhosis, liver failure and its complications, or receipt of a liver transplant.

In the study, the incidence rate of serious liver disease was found to be 8.19 per 10,000 person - years among those with newly diagnosed diabetes and 4.17 per 10,000 person-years among those without diabetes.

The researchers also noted that persons with diabetes and concomitant obesity or hypertension had the highest risk of liver disease. "We posit that the presence of overt diabetes reflects more severe insulin resistance, a greater fatty load in the liver, and potentially worse hepatic inflammation and injury," wrote study authors Joel Ray and Gillian Booth of St Michael's Hospital. "Those who have diabetes may not just have higher blood sugars, but greater long-term insulin resistance and fatty load to the liver, which ultimately impacts on the integrity of the liver's cells."

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User Comments

18 September, 2010 | shambhavi | Reply

My friend has labile diabetes. She has tried different kinds of medication different doses of the same but everything seems to have some sort of side effect or it does not control her sugar level. She is careful with her diet and does not go gungho over food, hardly touches sweets has plenty of vegetables and fibre rich food. Yet her fasting and post prandial are around 350+. The 2 draw backs with her are she does not like to go for a walk or exercise and she is always talking about her health and talks of downslide. Can these two be sufficient to have erratic blood sugar levels?

20 September, 2010 | Sangeetha Narayana Swamy | Reply

Dear Shambhavi,

A lot of factors like nutritious and balanced diet, exercise or walking, the quality, quantity and timings of meals, positive thinking, no stress and fretting etc help in control of blood sugars.

I hope she undergoes a complete diabetic check once in 6 months to check all the parameters concerned with diabetes. It looks like she is sub-consciously worrying about her sugars and getting stressed with that. Consult a diabetalogist, who will advice on insulin for better control of blood sugars. Ask her to walk for about 40 mins daily, practice breathing exercises and medication to relax her mind.

She can also register on our website for a Glucose control program, to keep track of her diet and exercise.

Thank you for your query.

30 August, 2010 | Kanika Jain | Reply

You are absolutely right Geetanjali. In a recent study published in online issue of Neurology, it was reported that having insulin resistance or type 2 diabetes can raise the risk of developing the brain plaques associated with Alzheimer's disease.
Even after adjusting for other risk factors, people with the highest levels of fasting insulin had nearly six times the odds of having plaque deposits between nerves in the brain, compared to people with the lowest levels of fasting insulin.
Thanks and regards,
Kanika Jain
Dietitian
NutritionVista

30 August, 2010 | Geetanjali Kelkar | Reply

In addition to liver disease, diabetes also causes Alzheimer's disease. Uncontrolled blood sugar increases the plaques in brain, brain tangles and dementia typically seen in Alzheimer's. This again highlights the importance of blood glucose control with diet and exercise in diabetics

27 July, 2010 | padma | Reply

dear samanitha, there are certain suggested lab tests for diabetics to be done regularly issued by American Diabetes Asoociation. (ADA guidelines). the frequency for a liver function tests for diabetes is once in 6 months, which you can remenber. in specific you can go for SGOT AND SGPT to find the status of liver with respect to its functioning and if abnormal, dietary modifications can be made accordingly. Have a happy living!!!

20 July, 2010 | Samanhita | Reply

IS the liver affected because of obesity complicated by Diabetes or is it due to uncontrolled Diabetes. My father in law has a problem, the doctors are not able to control his blood sugar levels and regularly he gets his eyes, foot and kidney checked .I am worried now do we have to get his liver tests done regularly too?

21 July, 2010 | Sangeetha Narayana Swamy | Reply

Dear Samanhita,

Poorly controlled blood glucose levels generally increases the risk of Non-
alcoholic fatty liver disease (NAFLD). Having elevated cholesterol levels and being obese further increases the risk of NAFLD. Also some medications used to treat the above mentioned conditions cause damage to the liver, which is very rare. The incidence of NAFLD is therefore high in diabetics.

Having a good control over blood glucose, maintaining a healthy weight, lowering the cholesterol levels and avoiding the consumption of alcohol is the best defense against liver damage.

Your doctor too would recommend regular liver function tests along with the diabetic profile tests to rule out Liver damage. Please talk to your doctor if your father in law has not got his liver function test done in the last 6 months.

Thank you for your query,
Best Regards,
Sangeetha Narayana Swamy,
Senior Dietitian,
NutritionVista.com

21 July, 2010 | Kanika Jain | Reply

Dear Samanhita,
Person suffering from diabetes for long have insulin resistance and greater fatty load to liver. Presence of co-morbidities like obesity and\or hypertension put person even at higher risk for liver disease.

We appreciate that your father in law gets regularly screened for eyes, foot and kidney complications.

Regarding undergoing liver tests, his medical health care provider would be best person to guide.
Please feel free to ask us any questions on diet. We would be glad to help you.

Regards,
Kanika Jain
Dietitian
NutritionVista

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