The name ‘non-alcoholic fatty liver disease’ is given to a group of conditions that are caused by fat build-up in the liver. When fat does this, the cells where it is stored become inflamed and your liver increases in size, which can progress to more serious conditions, including fibrosis and cirrhosis of the liver. Diabetes doesn’t cause this, but rather it often occurs alongside fatty liver disease because both are caused by similar factors, such as obesity and insulin resistance.
Fatty liver disease is ‘present arguably in a majority of type 2 diabetics,’ according to Daniel Einhorn, MD, clinical professor of medicine at the University of California and the medical director of the Scripps Whittier Diabetes Institute. ‘None of us thought about it more than about 10 years ago, then all of a sudden we discovered it and see it all the time.’ Though Einhorn says most cases of fatty liver disease do not cause any harm, in the US fatty liver disease is now a leading cause of end-stage (fatal) liver disease requiring a liver transplant, along with alcohol abuse and hepatitis.
Einhorn says 99% of fatty liver disease cases are detected by the liver enzyme tests that are part of routine diabetic blood medical exams, because the disease presents no symptoms. It is also not treated as a separate disease, and so doctors don’t tend to pin down the diagnosis with any additional studies unless your liver enzymes elevate unexpectedly and it appears that something else may be going on. Fatty liver disease is treated indirectly with lifestyle changes, such as losing weight, getting in better physical shape, and controlling the levels of sugar and fats in your blood that can contribute to fatty liver. Einhorn says that after this you simply ‘hope that the fatty liver responds to that control’ you’ve taken over your body.
However, it’s not a given that your diabetes will go hand-in-hand with fatty liver disease, as you can prevent it from developing by treating obesity, insulin resistance, and high levels of triglycerides in the blood. You can protect your liver, as well as your wellness, with a healthy weight, regular exercise, and control of your blood sugar and triglyceride levels.