Diabetes Self-Management Blog

Isn’t there enough to contend with having diabetes? You need to take care of your eyes, feet, heart… Now you have to worry about your liver? Well, yes. Fatty liver disease may be something you’re not all that familiar with, but if you have Type 2 diabetes, it’s a good idea to know about this. Hence this week’s posting!

Liver 101
Let’s back up for a minute and talk about your liver. The liver is one of the largest organs in the body, weighing about three pounds. It’s located in the right upper abdomen, below the diaphragm. It’s pretty amazing what the liver does, if you stop and think about it. Here’s a brief run-down:

• Detoxifies harmful substances
• Produces proteins that help blood to clot
• Breaks down fat for energy
• Makes bile (which is needed for fat breakdown)
• Helps keep blood glucose levels constant
• Metabolizes protein
• Stores vitamins and minerals

Given all that the liver does, you can see why it’s so important to keep it in shape.

Fatty liver disease
The actual name of this condition is non-alcoholic fatty liver disease, or NAFLD, for short. This is a condition in which extra fat builds up in liver cells, and, as the name implies, it’s not due to drinking alcohol (that’s a whole other issue). The liver normally contains some fat, but if more than 5% to 10% of the liver’s weight is due to fat, you’ve got a fatty liver.

Who gets NAFLD? It’s most common in people who:

• Are overweight or obese
• Have Type 2 diabetes
• Have high blood cholesterol or triglycerides
• Are losing weight quickly
• Have poor eating habits

NAFLD can run in the family. It may also be caused by certain medicines and viral hepatitis. But according to the American Liver Foundation, some people have NAFLD and have no risk factors. It’s the most common cause of liver disease in the US and affects up to 25% of people in the United States. NAFLD is also a leading cause of end-stage liver disease requiring liver transplantation (other causes include hepatitis and alcohol abuse). If not treated, this disease can lead to swelling of the liver, cirrhosis, liver cancer, or liver failure.

NAFLD symptoms
NAFLD usually causes no symptoms in the early stages of the disease. Symptoms may occur as the disease progresses, and include fatigue, weakness, weight loss, yellowing of the skin and eyes, itching, fluid buildup, and confusion. A person may feel pain in the right upper part of the abdomen and have patches of dark skin on the neck or under the arms.

Diagnosis
NAFLD may be diagnosed during a regular physical exam. Your provider may notice that your liver is enlarged. Or you might report that you’ve been having right upper quadrant pain. Liver enzymes may be checked through a blood test (high levels are suspicious), and a fatty liver can show up on an ultrasound. A definitive diagnosis is made by having a liver biopsy, which can detect extra fat, inflammation, and damaged liver cells.

Treatment
There’s no medical treatment for NAFLD at this time. The thiazolidinedione drugs Avandia (rosiglitazone) and Actos (pioglitazone) have been shown to reduce fat in the liver, but these are not FDA-approved to be used for NAFLD. However, as with diabetes, lifestyle changes can help. Losing weight (if you need to), controlling your blood glucose and cholesterol levels, cutting down on refined carbohydrate foods, getting more physical activity, and avoiding alcohol all can help prevent the condition from worsening and, in the early stages, may even reverse NAFLD. In addition, talk with your provider before taking certain medicines or dietary supplements, as some can be harmful to the liver.

Do what you can to keep your liver healthy. Talk to your health-care provider to learn more or if you have any of the symptoms previously mentioned.

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