If I have diabetes, is there anything special I need to do to take care of my liver?
Answer From M. Regina Castro, M.D.
You're wise to wonder about steps to protect your liver. Diabetes raises your risk of nonalcoholic fatty liver disease, a condition in which excess fat builds up in your liver even if you drink little or no alcohol.
This condition occurs in at least half of those with type 2 diabetes. It isn't clear whether the condition appears more often in people with type 1 diabetes than in the general population because obesity, which is a risk factor, occurs with similar frequency in both groups. Other medical conditions, such as high cholesterol and high blood pressure, also raise your risk of nonalcoholic fatty liver disease.
Fatty liver disease itself usually causes no symptoms. But it raises your risk of developing liver inflammation or scarring (cirrhosis). It's also linked to an increased risk of liver cancer, heart disease and kidney disease.
Fatty liver disease may even play a role in the development of type 2 diabetes. Once you have both conditions, poorly managed type 2 diabetes can make fatty liver disease worse.
Your best defense against fatty liver disease includes these strategies:
- Work with your health care team to achieve good control of your blood sugar.
- Lose weight if you need to, and try to maintain a healthy weight.
- Take steps to reduce high blood pressure.
- Keep your low-density lipoprotein (LDL, or "bad") cholesterol and triglycerides — a type of blood fat — within recommended limits.
- Don't drink too much alcohol.
If you have diabetes, your doctor may recommend an ultrasound examination of your liver when you're first diagnosed and regular follow-up blood tests to monitor your liver function.
M. Regina Castro, M.D.
Aug. 26, 2017
- Sheth SG, et al. Epidemiology, clinical features, and diagnosis of nonalcoholic fatty liver disease in adults. https://www.uptodate.com/contents/search. Accessed July 12, 2017.
- Bush H, et al. Pediatric non-alcoholic fatty liver disease. Children. 2017;4:48.
- Bhatt BH, et al. Fatty liver disease in diabetes mellitus. Hepatobiliary Surgery and Nutrition. 2015;4:101.
- Hazlehurst JM, et al. Nonalcoholic fatty liver disease and diabetes. Metabolism. 2016;65:1096.
- Definition and facts of NAFLD and NASH. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/definition-facts. Accessed July 12, 2017.
- Castro MR (expert opinion). Mayo Clinic. Rochester, Minn. July 13, 2017.