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Liver Disease And Glucose Levels

Healing Leaky Livers

Healing Leaky Livers

It may surprise you to know that, for many people, Type 2 diabetes is primarily a liver disease. The pancreas damage comes later. Is there anything we can do to heal a diabetic liver? Liver issues in diabetes are complicated. An article in the journal Clinical Diabetes explained that diabetes can cause liver disease; liver disease can cause diabetes; or both can arise together from other causes. Whichever comes first, the sick liver may produce way too much glucose, enough to overwhelm the body’s insulin. Why would a liver start pumping out unneeded glucose? Unhealthy livers tend to have a lot of fat in them, a condition called nonalcoholic fatty liver disease, or NAFLD. You don’t have to be fat to have a fatty liver (although overweight and obesity are risk factors). Thin people get it too, and the causes of NAFLD are unknown. Some are thought to be genetic. However, a recent animal study published in the journal PLOS One found that prenatal exposure to alcohol (from a mother who drank while pregnant) is strongly associated diabetes-like glucose production by the liver. There are probably other causes as well, including environmental chemicals and possibly unhealthy diets. A rat study in the Journal of Biological Chemistry found that fatty livers became more resistant to insulin. The researchers found processes by which insulin normally tells the liver to stop producing unwanted glucose. Excess fat in the liver seemed to block these processes, so too much glucose was produced. Human livers apparently act the same way. An Italian study in The American Journal of Medicine found that subjects with NAFLD had high fasting and postmeal insulin levels, high insulin resistance, and high triglyceride levels. (Triglycerides are a kind of blood fat.) High insulin levels can b Continue reading >>

The Liver & Blood Sugar

The Liver & Blood Sugar

During a meal, your liver stores sugar for later. When you’re not eating, the liver supplies sugar by turning glycogen into glucose in a process called glycogenolysis. The liver both stores and produces sugar… The liver acts as the body’s glucose (or fuel) reservoir, and helps to keep your circulating blood sugar levels and other body fuels steady and constant. The liver both stores and manufactures glucose depending upon the body’s need. The need to store or release glucose is primarily signaled by the hormones insulin and glucagon. During a meal, your liver will store sugar, or glucose, as glycogen for a later time when your body needs it. The high levels of insulin and suppressed levels of glucagon during a meal promote the storage of glucose as glycogen. The liver makes sugar when you need it…. When you’re not eating – especially overnight or between meals, the body has to make its own sugar. The liver supplies sugar or glucose by turning glycogen into glucose in a process called glycogenolysis. The liver also can manufacture necessary sugar or glucose by harvesting amino acids, waste products and fat byproducts. This process is called gluconeogenesis. When your body’s glycogen storage is running low, the body starts to conserve the sugar supplies for the organs that always require sugar. These include: the brain, red blood cells and parts of the kidney. To supplement the limited sugar supply, the liver makes alternative fuels called ketones from fats. This process is called ketogenesis. The hormone signal for ketogenesis to begin is a low level of insulin. Ketones are burned as fuel by muscle and other body organs. And the sugar is saved for the organs that need it. The terms “gluconeogenesis, glycogenolysis and ketogenesis” may seem like compli Continue reading >>

Diabetes: How Do I Help Protect My Liver?

Diabetes: How Do I Help Protect My Liver?

If I have diabetes, is there anything special I need to do to take care of my liver? Answers 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. Continue reading >>

Preventing Fatty Liver Disease (nafld)

Preventing Fatty Liver Disease (nafld)

When was the last time you had a chat with your doctor about your liver? Can’t remember? Maybe never? Well, it’s probably time to do so. Most people who have diabetes think very little about the connection between liver disease and Type 2 diabetes. But statistics show that at least 50% of those with Type 2 will develop fatty liver disease, and some research shows that figure may even be as high as 70%. What is fatty liver disease? To be more exact, fatty liver disease is technically called “non-alcoholic fatty liver disease,” or NAFLD, for short. As the name implies, it’s characterized by a buildup of fat in the liver that’s unrelated to drinking alcohol. The extent of fat buildup can determine the extent of liver damage, ranging from a small accumulation of fat (called steatosis) to a large amount that causes inflammation (called steatohepatitis). Without treatment, NAFLD can progress to cirrhosis (chronic scarring and damage), liver failure, and possibly liver cancer. What causes NAFLD? NAFLD is becoming increasingly common; in fact, it’s the most common type of liver disease in the developed world. It’s also a very complex condition. There’s no one specific cause, but it appears that this disease is linked to: • Being overweight or obese • Having insulin resistance (a condition whereby the body doesn’t use its own insulin properly) • Having high blood sugar levels (prediabetes or Type 2 diabetes) • Having high levels of fat, called triglycerides, in the blood • Having sleep apnea • Having PCOS (polycystic ovary syndrome) In addition, NAFLD is more common in older people, men, people who have Type 2 diabetes, and people who have excess weight around their middle (like a “spare tire” or a “muffin top”). What happens in NAFLD? The Continue reading >>

The Liver And Diabetes

The Liver And Diabetes

Tweet The liver is one of the most important organs in our bodies, playing a central role in a number of important processes. One of these is to help control glucose concentration in the blood (i.e. regulating blood glucose levels). A healthy liver helps keep blood glucose within the ‘normal range’ and protects against excessive fluctuations, which is vital as high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia) can both be dangerous for the human body. What is the liver? The liver is the largest internal organ of the human body, weighing approximately 1.4 kg (3 lb) in the average adult. Located under your diaphragm (more to the right side of your body), it is a wedge-shaped, spongy organ that performs a number of key functions, including regulating blood sugar levels, getting rid of toxins (body detoxification) and bile production. It also acts as a major filter of the blood travelling from the digestive tract to the rest of the body. The liver’s response to stress The body responds to stress by releasing hormones from the adrenal glands within the kidneys. These hormones travel within the blood to the liver and trigger the liver to release some of its stored glycogen. Release of glucose into the blood is part of the body’s ‘fight or flight’ response, preparing the body with energy to be able to quickly respond to a threat or stressful situation. Read more on stress and blood glucose levels The liver’s response to exercise During exercise, or other forms of physical activity, the liver plays a part in regulating blood glucose levels. When you begin physical activity, glycogen from the muscles are mobilised to be used as a source of fuel. As glucose is taken up by the muscles, the liver releases glucose into the blood. The liver can only sto Continue reading >>

Liver Disease And Diabetes Mellitus

Liver Disease And Diabetes Mellitus

CLINICAL DIABETES VOL. 17 NO. 2 1999 These pages are best viewed with Netscape version 3.0 or higher or Internet Explorer version 3.0 or higher. When viewed with other browsers, some characters or attributes may not be rendered correctly. FEATURE ARTICLE Gavin N. Levinthal, MD, and Anthony S. Tavill, MD, FRCP, FACP IN BRIEF Liver disease may cause or contribute to, be coincident with, or occur as a result of diabetes mellitus. This article addresses these associations. This article addresses the role of the liver in normal glucose homeostasis and discusses a variety of liver conditions associated with abnormal glucose homeostasis. This association may explain the pathogenesis of the liver disease or of the abnormal glucose homeostasis, or may be purely coincidental (Table 1). Table 1. Liver Disease and Diabetes Mellitus 1. Liver disease occurring as a consequence of diabetes mellitus Glycogen deposition Steatosis and nonalcoholic steatohepatitis (NASH) Fibrosis and cirrhosis Biliary disease, cholelithiasis, cholecystitis Complications of therapy of diabetes (cholestatic and necroinflammatory) 2 . Diabetes mellitus and abnormalities of glucose homeostasis occurring as a complication of liver disease Hepatitis Cirrhosis Hepatocellular carcinoma Fulminant hepatic failure Postorthotopic liver transplantation 3 . Liver disease occurring coincidentally with diabetes mellitus and abnormalities of glucose homeostasis Hemochromatosis Glycogen storage diseases Autoimmunebiliary disease The prevalence of type 1 diabetes in the United States is ~0.26%. The prevalence of type 2 diabetes is far higher, ~1–2% in Caucasian Americans and up to 40% in Pima Indians. According to the Centers for Disease Control and Prevention, hepatitis C alone chronically infects more than 1.8% of the A Continue reading >>

Why You Should Know About Fatty Liver Disease

Why You Should Know About Fatty Liver Disease

Non-alcoholic fatty liver disease can be a problem for people with diabetes, especially type 2 diabetes. Learn more about this growing condition. Fatty liver disease is an “underappreciated problem that seems to be getting worse,” according to Mitch Lazar, MD, PhD, chief of the division of endocrinology, diabetes and metabolism at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. For many years physicians believed that fatty liver was a benign condition but in 1980 non-alcoholic fatty liver disease (NAFLD) was designated a real condition. “Fortunately with increasing knowledge and research on the disease, there is a growing awareness,” says Dina Halegoua-Demarzio, MD, director of the Fatty Liver Center at Thomas Jefferson University Hospital, also located in Philadelphia. “More awareness of the problem in doctors and patients will enable early intervention that can prevent cirrhosis, liver failure and liver cancer.” It’s a particular issue for people with type 2 diabetes. Up to 70 percent of obese type 2 diabetes patients have fatty livers, meaning at least five percent of liver cells show evidence of fat. Although fatty livers are benign and estimates vary considerably, about five to 10 percent of people with the condition will go on to develop the more serious non-alcoholic steatohepatitis (NASH) that causes inflammation, scarring and damage to the liver cells. 1 Fatty livers can also start a cascade of serious damage to the liver and attempts by the organ to regenerate itself that culminate in an abundance of scar tissue and impaired liver function. It has also been linked to increased risk of heart attack and stroke.2 Studies show that anywhere from three to 26 percent of people with NASH will progress to cirrhosis, whi Continue reading >>

What Causes The Blood Glucose Level To Increase In Liver Damage?

What Causes The Blood Glucose Level To Increase In Liver Damage?

Chronic liver damage can result in the replacement of normal liver tissue with non-functioning scar tissue. Advanced liver damage is called cirrhosis, and glucose intolerance is a common feature of this condition. An article in the January 2009 issue of the “World Journal of Gastroenterology” reports that greater than 90 percent of people with liver cirrhosis are glucose intolerant, and nearly 30 percent will develop diabetes. Liver cirrhosis is irreversible and can be the result of alcoholic liver disease, hemochromatosis, non-alcoholic fatty liver disease or chronic hepatitis C infection. Video of the Day The liver is the primary disposal site of insulin; when the liver is damaged, less insulin is taken up and degraded, causing a condition of chronic hyperinsulinemia. A study in the July 1998 issue of “Hepatology” reports that hyperinsulinemia in patients with liver cirrhosis causes muscle insulin resistance. Another study in the March 1994 issue of “Hepatology” reports patients with cirrhosis exhibit metabolic abnormalities consistent with muscle tissue insulin resistance. This means that in people with impaired liver function, glucose is not as efficiently removed from the blood by muscle tissue, leading to a chronic elevation of blood glucose levels. Liver Insulin Resistance In people who have cirrhosis, insulin resistance eventually develops in the liver also. When the liver is less sensitive to insulin, it is no longer as effective in removing excess glucose from the blood or in converting glucose into the glucose-storage molecule, glycogen. As a result, blood glucose levels are higher, especially after a meal. Chronic insulin resistance and the resultant high circulating levels of glucose and fats eventually destroy the insulin-secreting cells, calle Continue reading >>

How Sugar Messes Up Your Liver And Gives You Diabetes

How Sugar Messes Up Your Liver And Gives You Diabetes

Modern man is plagued with many diseases that you will not find in some "primitive" populations like modern hunter-gatherers. These include obesity, heart disease, some cancers and last but not least, type II diabetes... which has reached epidemic proportions in the past few decades and now afflicts about 300 million people worldwide. This disease is a common cause of early death, blindness, amputation and a severely decreased quality of life... and it is advancing rapidly, every single year. In the video above, Dr. Robert H. Lustig and Dr. Elissa S. Epel explain how excess sugar can mess up liver metabolism and ultimately lead to diabetes. Dr. Lustig recently took part in a study where they examined the associations between sugar consumption and diabetes in 175 countries (1). They found very clear associations, where each 150 kcal (about one can of soda) per day of sugar increased the prevalence of diabetes by 1.1%. To put this number in perspective, if all of the U.S. added one can of soda to their daily diet, almost 3.5 million more people would become diabetic. In this study, added sugar was the only part of the diet that correlated with diabetes when they adjusted for confounding factors. These types of studies are so-called observational studies, which can not prove that one thing caused another, it can only show that they are correlated. However, there are other lines of evidence linking sugar to the development of type II diabetes and this specifically involves how sugar affects the liver. Sugar is composed of two molecules... glucose and fructose. Glucose can be metabolized by every cell in the body and if we don't get it from the diet, our bodies make it. However, fructose is different. The only organ that can metabolize sugar is the liver, because only the li Continue reading >>

The Liver And Blood Glucose Levels

The Liver And Blood Glucose Levels

Tweet Glucose is the key source of energy for the human body. Supply of this vital nutrient is carried through the bloodstream to many of the body’s cells. The liver produces, stores and releases glucose depending on the body’s need for glucose, a monosaccharide. This is primarily indicated by the hormones insulin - the main regulator of sugar in the blood - and glucagon. In fact, the liver acts as the body’s glucose reservoir and helps to keep your circulating blood sugar levels and other body fuels steady and constant. How the liver regulates blood glucose During absorption and digestion, the carbohydrates in the food you eat are reduced to their simplest form, glucose. Excess glucose is then removed from the blood, with the majority of it being converted into glycogen, the storage form of glucose, by the liver’s hepatic cells via a process called glycogenesis. Glycogenolysis When blood glucose concentration declines, the liver initiates glycogenolysis. The hepatic cells reconvert their glycogen stores into glucose, and continually release them into the blood until levels approach normal range. However, when blood glucose levels fall during a long fast, the body’s glycogen stores dwindle and additional sources of blood sugar are required. To help make up this shortfall, the liver, along with the kidneys, uses amino acids, lactic acid and glycerol to produce glucose. This process is known as gluconeogenesis. The liver may also convert other sugars such as sucrose, fructose, and galactose into glucose if your body’s glucose needs not being met by your diet. Ketones Ketones are alternative fuels that are produced by the liver from fats when sugar is in short supply. When your body’s glycogen storage runs low, the body starts conserving the sugar supplies fo Continue reading >>

Spectrum Of Liver Disease In Type 2 Diabetes And Management Of Patients With Diabetes And Liver Disease

Spectrum Of Liver Disease In Type 2 Diabetes And Management Of Patients With Diabetes And Liver Disease

It is estimated that 20.8 million people, i.e., 7.0% of the U.S. population, have diabetes (1). Type 2 diabetes, with its core defects of insulin resistance and relative insulin deficiency, accounts for 90–95% of those with the disease. Another 5.2 million people are estimated to have undiagnosed type 2 diabetes. It is the sixth leading cause of death (1) in the U.S. and accounts for 17.2% of all deaths for those aged >25 years (2). Liver disease is an important cause of death in type 2 diabetes. In the population-based Verona Diabetes Study (3), cirrhosis was the fourth leading cause of death and accounted for 4.4% of diabetes-related deaths. The standardized mortality ratio (SMR), i.e., the relative rate of an event compared with the background rate, for cirrhosis was 2.52 compared with 1.34 for cardiovascular disease (CVD). In another prospective cohort study (4), cirrhosis accounted for 12.5% of deaths in patients with diabetes. Diabetes, by most estimates, is now the most common cause of liver disease in the U.S. Cryptogenic cirrhosis, of which diabetes is, by far, the most common cause, has become the third leading indication for liver transplantation in the U.S. (5,6). Virtually the entire spectrum of liver disease is seen in patients with type 2 diabetes. This includes abnormal liver enzymes, nonalcoholic fatty liver disease (NAFLD), cirrhosis, hepatocellular carcinoma, and acute liver failure. In addition, there is an unexplained association of diabetes with hepatitis C. Finally, the prevalence of diabetes in cirrhosis is 12.3–57% (7). Thus, patients with diabetes have a high prevalence of liver disease and patients with liver disease have a high prevalence of diabetes. The management of diabetes in patients with liver disease is theoretically complicated b Continue reading >>

What Every Diabetic Should Know About Liver Disease

What Every Diabetic Should Know About Liver Disease

What Every Diabetic Should Know About Liver Disease Did you know that diabetics are 50% more likely to develop liver disease? Particularly fatty liver disease. Fatty liver disease is incredibly common in overweight people; nearly everyone with excess weight on their abdomen has some degree of fatty liver. Type 2 diabetics are prone to carrying excess weight on their abdomen, but even slim diabetics often have a fatty liver. It is well known that diabetes increases the risk of kidney disease, nerve damage, blood vessel damage, infections, blindness, erectile problems and heart disease, but you may not realise diabetes has terrible effects on the liver. You can’t see or feel the effects it’s having on your liver until liver cells become damaged. According to Gillian Booth, MD, MSc, of St. Michael’s Hospital in Toronto, in a population-based study, newly diagnosed diabetes was linked with a near doubling in the rate of cirrhosis, liver failure or liver transplant compared with non-diabetics. Clearly these are significant findings that should be taken seriously. Insulin resistance (syndrome X) is the driving force behind the development of fatty liver. Insulin resistance is a forerunner to type 2 diabetes. If the insulin resistance becomes severe enough, a person usually develops type 2 diabetes. Type 1 diabetes usually develops in childhood, although by the time they are in their mid 30s, most type 1 diabetics have developed insulin resistance as well, and they face the same risks as type 2 diabetics when they get older. People with insulin resistance have high levels of insulin in their bloodstream. Insulin signals to your liver to manufacture fat, especially triglycerides and cholesterol. This promotes the accumulation of fat inside the liver, inside other organs, Continue reading >>

Cirrhosis

Cirrhosis

On this page: What are the signs and symptoms of cirrhosis? What is cirrhosis? Cirrhosis is a condition in which the liver slowly deteriorates and is unable to function normally due to chronic, or long lasting, injury. Scar tissue replaces healthy liver tissue and partially blocks the flow of blood through the liver. The liver is the body’s largest internal organ. The liver is called the body’s metabolic factory because of the important role it plays in metabolism—the way cells change food into energy after food is digested and absorbed into the blood. The liver has many functions, including taking up, storing, and processing nutrients from food—including fat, sugar, and protein—and delivering them to the rest of the body when needed making new proteins, such as clotting factors and immune factors producing bile, which helps the body absorb fats, cholesterol, and fat-soluble vitamins removing waste products the kidneys cannot remove, such as fats, cholesterol, toxins, and medications A healthy liver is necessary for survival. The liver can regenerate most of its own cells when they become damaged. However, if injury to the liver is too severe or long lasting, regeneration is incomplete, and the liver creates scar tissue. Scarring of the liver, also called fibrosis, may lead to cirrhosis. The buildup of scar tissue that causes cirrhosis is usually a slow and gradual process. In the early stages of cirrhosis, the liver continues to function. However, as cirrhosis gets worse and scar tissue replaces more healthy tissue, the liver will begin to fail. Chronic liver failure, which is also called end-stage liver disease, progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or effectively rep Continue reading >>

Alpha-1 Liver Disease Associated Conditions

Alpha-1 Liver Disease Associated Conditions

Alpha-1 Liver Disease Associated Conditions Alpha-1 Liver Disease Associated Conditions How does Alpha-1 liver disease affect other organs and systems? The liver is anatomically or physiologically connected to all the bodys vital systems (e.g., brain, heart, kidneys). Toxins build up in the blood and brain, because a cirrhotic liver is ineffective at removing them. Toxins can slow mental functioning and cause changes in personality, forgetfulness, trouble concentrating, neglect of personal appearance, changes in sleep habits, unresponsiveness, coma and even death. Hormones that dilate the systemic blood vessels and lower the blood pressure are present in higher concentrations in people with cirrhosis. They may experience lightheadedness and syncope (fainting). This condition will make the heart pump faster and stronger and eventually lead to heart failure. High blood pressure in the pulmonary artery (pulmonary hypertension) This condition will lead to low oxygen saturations (hypoxemia) and difficulty breathing (dyspnea) . A cardiac ultrasound can suggest the diagnosis. A right heart catheterization confirms it. Pulmonary hypertension is a severe complication of liver cirrhosis, and its diagnosis is a strong indication of the need for liver transplant. High blood pressure in the liver circulation (portal hypertension) In cirrhosis, blood flow through the liver is blocked by scar tissue formation and backs up enlarging the spleen and the blood vessels of the stomach and esophagus. Enlarged blood vessels of this type are called varices. Varices cannot handle high flow or elevated pressure without bursting easily. When distended, these varices can burst and cause severe bleeding (a serious emergency that requires immediate medical attention). The liver makes important clot Continue reading >>

Must Read Articles Related To Low Blood Sugar (hypoglycemia)

Must Read Articles Related To Low Blood Sugar (hypoglycemia)

A A A Hypoglycemia (Low Blood Sugar) Hypoglycemia (low blood sugar) is a commonly perceived problem. In actuality, while some or many of the symptoms may be present, it is rarely confirmed or documented. The presence of true, documented hypoglycemia in the absence of diabetes treatment must be evaluated comprehensively by an endocrinologist. Hypoglycemia most often affects those at the extremes of age, such as infants and the elderly, but may happen at any age. Generally, hypoglycemia is defined as a serum glucose level (the amount of sugar or glucose in your blood) below 70 mg/dL. As a medical problem, hypoglycemia is diagnosed by the presence of three key features (known as Whipple's triad). Whipple's triad is: symptoms consistent with hypoglycemia, a low plasma glucose concentration, and relief of symptoms after the plasma glucose level is raised. Symptoms of hypoglycemia typically appear at levels below 60 mg/dL. Some people may feel symptoms above this level. Levels below 50 mg/dL affect brain function. The body regulates its glucose level—the primary source of energy for the brain, muscles, and other essential cells - by the actions of different hormones. These hormones include insulin (which lowers the blood sugar level) and other chemicals which raise blood sugar (such as glucagon, growth hormone, and epinephrine). Both insulin and glucagon are manufactured in the pancreas, an organ near the stomach which assists the digestive tract. Special cells in the pancreas, called beta cells, make insulin. Alpha cells in the pancreas make glucagon. The role of insulin is to help in the absorption of glucose from the blood by causing it to be stored in the liver or be transported into other tissues of the body (for metabolism or storage). Glucagon increases the amount of Continue reading >>

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