The Link between Diabetes and Fatty Liver

Fatty liver impairs insulin functioning and precipitates insulin resistance leading to Type 2 diabetes (T2D). Reducing hepatic fat contributes to improving insulin action in the liver and, thus, diabetes reversal, says Dr. V. Mohan from Chennai. 

The liver plays a crucial role in insulin function, and fat accumulation can precipitate T2D. Metabolic dysfunction-associated steatotic liver disease (MASLD) and diabetes have a bidirectional relationship, with NAFLD predisposing individuals to T2D and vice versa. Fat buildup in the liver hampers fasting glucose-level control and strains the pancreas, accelerating the progression of diabetes. 

Evidence suggesting that NAFLD increases the risk of developing T2D remains strong, and NAFLD severity is directly associated with new-onset diabetes risk. However, reducing hepatic and pancreatic fat can improve insulin action in the liver and potentially reverse T2D. Intense caloric restriction and weight loss have shown positive effects in lowering hepatic and pancreatic fat, aiding in improved insulin action.

Neglecting MASLD can result in inflammation, metabolic dysfunction-associated steatohepatitis (MASH), cirrhosis, hepatic encephalopathy, and even hepatocellular carcinoma (HCC). Prevention, early diagnosis, and lifestyle modifications are crucial for managing MASLD. Controlling diabetes, dyslipidemia, avoiding smoking and alcohol, and adopting a healthy diet and regular exercise are recommended. 

Some drugs have shown promise in reducing NAFLD, but prevention remains the best approach. Regular liver function tests and ultrasounds are advised, and further diagnostic tests may be needed if abnormalities are detected. Early diagnosis facilitates effective intervention and disease reversal.

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