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 >>
Fatty Liver Disease: Complex Condition Can Also Damage Other Organs
Fatty liver disease is a major public health concern because it leads to serious and often fatal liver conditions, including cancer. The condition is linked to chronic liver diseases it as cirrhosis - where the liver shrinks and can lead to liver failure. Experts have warned it can also increase the risk of type 2 diabetes. If the liver is damaged - and a person has fatty liver disease, it produced glucose and unfavourable fats and proteins. These including hepatokine fetuin-A which release into the bloodstream which can trigger inflammation. This means the substances from the organ enter other organs. Now scientists have warned fatty liver disease can cause damage to other organs, including the pancreas. According to experts from the German Centre for Diabetes Research and the University of Tübingen, the pancreas is one of the worst affected by this, but scientists haven’t previously discovered why. Type 2 diabetes occurs when the pancreas can't make enough insulin or the insulin produced doesn’t work properly, and blood glucose levels rise. Tue, August 22, 2017 Liver disease: Risk factors for non-alcoholic fatty liver disease (NAFLD). The pancreas is a large gland that lies behind the stomach, at the back of the tummy area. The organ makes hormones, including insulin, which controls the level of sugar in the blood. It also makes enzymes, which help to digest food. Experts analysed 200 subjects with an increased risk of type 2 diabetes and their pancreatic fat content was measured by MRI scans. Scientists found that in people who already had poorly regulated blood glucose levels, an an increased pancreatic fatty degeneration was associated with a reduced levels of insulin. The investigations were carried out by Professor Hans Ulrich Häring and the Endocrinology R Continue reading >>
High Liver Enzymes & High Blood Sugar
A simple blood test can check liver enzyme levels. Elevated levels can indicate liver damage; liver function is usually tightly regulated, but a damaged liver can "leak" extra enzymes into the bloodstream because its function is compromised. This liver damage can be acute or chronic. With either type of liver damage, many physiological functions, including blood sugar control, can be affected. It is important to correct the underlying cause of the liver dysfunction to prevent serious, long-term consequences. Video of the Day The pancreas and liver regulate blood sugar. During digestion, all carbohydrates are eventually broken down into glucose, which is released into the bloodstream. The pancreas senses this increase in blood sugar and signals the secretion of insulin to the surface of cells throughout the body; insulin helps pull glucose from the blood and into the cell where it can be used for energy. Excess glucose is sent to the liver, where it is stored as glycogen; glycogen is used for energy during a state of starvation. Functions of the Liver The liver is located in the upper right portion of the abdomen, and plays a very important and diverse role in the body. It has many functions, including creating bile to digest fat, regulating blood clotting and blood sugar, and producing and regulating proteins, cholesterol and fat transporters. Additionally, all drugs and chemicals that enter the body are first filtered by the liver; harmful substances are broken down and excreted by the kidneys. Liver and Blood Sugar The liver is where excess glucose is brought and stored as glycogen, and it works closely with other organ systems to regulate blood sugar. In a healthy person, the pancreas senses when blood sugar is low, and releases glucagon -- a hormone that signals to Continue reading >>
Fatty Liver (nonalcoholic Fatty Liver Disease, Nonalcoholic Steatohepatitis)
Nonalcoholic fatty liver disease definition facts Nonalcoholic fatty liver disease (non-alcoholic fatty liver disease, NAFLD) is the accumulation of abnormal amounts of fat within the liver. Nonalcoholic fatty liver disease can be divided into isolated fatty liver in which there is only accumulation of fat, and nonalcoholic steatohepatitis (NASH) in which there is fat, inflammation, and damage to liver cells. NASH progresses to scarring and ultimately to cirrhosis, with all the complications of cirrhosis, for example, gastrointestinal bleeding, liver failure, and liver cancer. The development of nonalcoholic fatty liver disease is intimately associated with and is probably caused by obesity and diabetes. Nonalcoholic fatty liver disease is considered a manifestation of the metabolic syndrome. The symptoms of nonalcoholic fatty liver disease are primarily those of the complications of cirrhosis in patients with NASH; isolated fatty liver infrequently causes symptoms and usually is discovered incidentally. The complications of cirrhosis include: The differentiation of isolated fatty liver from NASH usually requires a liver biopsy. The most promising treatments for nonalcoholic fatty liver disease are Several drugs have been studied in the treatment of NASH. There is little evidence that any drug is effective in slowing the disease progression of NASH. Many diseases are associated with NASH and are part of the metabolic syndrome. These diseases should be screened for and treated, for example, high blood pressure, dyslipidemia and diabetes. Isolated fatty liver rarely progresses to NASH or cirrhosis. Nonalcoholic fatty liver disease, including NASH affects young children as well. NASH will become the number one reason for liver transplantation unless effective and safe trea Continue reading >>
Fatty Liver Is More Dangerous Than You Might Realize. Here’s How To Heal It
“My doctor says I have a fatty liver and I should stay away from fat,” writes this week’s house call. “Are high-fat foods the culprit here? Any tips to help with a fatty liver?” Indeed, your doctor is right to feel concern: Fatty liver is a dangerous yet misunderstood disease. In America, it affects 90 million of us and 17 percent of our children. Think about foie gras, the French delicacy made from duck or goose liver. It is made by force-feeding the animals a combination of sugar with corn and starch (a really sad, horrible practice), intentionally creating a fatty liver. So if you’re gorging on sugar and starch, you’re essentially doing the same thing with your own liver. Fatty liver literally means your liver fills with fat, paving the path for chronic disease and inflammation. You might be surprised to learn the primary culprit here. Research shows that carbs (and not fat) produce more fat in your belly and liver. Sugar switches on fat production in your liver, creating an internal process called lipogenesis, which is your body’s normal response to sugar. Fructose, the most detrimental sugar that heads directly to your liver, actually ramps up lipogenesis. That explains why sugar, especially fructose, becomes the chief cause of liver disease and the leading cause of liver transplants. What’s so bad about having a fatty liver? Well, among its numerous repercussions include inflammation, which triggers insulin resistance and pre-diabetes, meaning your body deposits fat in your liver and organs including your belly (called visceral fat). It gets worse. Excess sugar and starch creates more serious problems including high triglycerides, low HDL (“good” cholesterol), and high amounts of small LDL (dangerous cholesterol particles that cause heart att Continue reading >>
Fatty Liver: What It Is, And How To Get Rid Of It
Fatty liver is linked to type 2. Find out more. By Franziska Spritzler, RD, CDE Fatty liver disease is becoming increasingly common in many parts of the world, affecting about 25% of people globally. It is linked to obesity, type 2 diabetes and other disorders characterized by insulin resistance. What’s more, if fatty liver isn’t addressed, it may progress to more serious liver disease and other health problems. What Is Fatty Liver? Fatty liver occurs when too much fat builds up in liver cells. Although it is normal to have a tiny amount of fat in these cells, the liver is considered fatty if more than 5% of it is fat. While drinking too much alcohol can lead to fatty liver, in many cases it does not play a role. A number of fatty liver conditions fall under the broad category of non-alcoholic liver disease (NAFLD), which is the most common liver disease in adults and children in Western countries. Non-alcoholic fatty liver (NAFL) is the initial, reversible stage of liver disease. Unfortunately, it often goes undiagnosed. Over time, NAFL may lead to a more serious liver condition known as non-alcoholic steatohepatitis, or NASH. NASH involves greater fat accumulation and inflammation that damages the liver cells. This can lead to fibrosis, or scar tissue, as liver cells are repeatedly injured and die off. Unfortunately, it is difficult to predict whether fatty liver will progress to NASH, which greatly increases the risk of cirrhosis (severe scarring that impairs liver function) and liver cancer. NAFLD is also linked to an increased risk of other diseases, including heart disease, diabetes and kidney disease. Bottom Line: Fatty liver occurs when too much fat builds up in the liver. Fatty liver is reversible at an early stage, but it sometimes progresses to advanced l Continue reading >>
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 >>
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 >>
Fatty Liver May Be Linked To Diabetes Risk
cells may raise your risk of developing type 2 diabetes regardless of the fat in other places of your body. A new study suggests that fatty liver disease, also known as fatty liver, may be an independent risk factor for type 2 diabetes. Researchers found people with fatty liver disease were significantly more likely to develop the disease within five years than those with healthy livers. “Many patients and practitioners view fat in the liver as just ‘fat in the liver,’ but we believe that a diagnosis of fatty liver should raise an alarm for impending type 2 diabetes,” says researcher Sun Kim, MD, of Stanford University in Calif., in a news release. “Our study shows that fatty liver, as diagnosed by ultrasound, strongly predicts the development of type 2 diabetes regardless of insulin concentration.” Researchers say fatty liver often occurs along with other risk factors for diabetes, such as obesity and insulin resistance, which has made it difficult to determine whether the condition itself is a marker for diabetes risk. But in this study, researchers found that even among those with similar insulin concentrations, those with fatty liver were still twice as likely to develop type 2 diabetes. Fatty liver is a common liver condition that occurs in about one-third of adults in the U.S. In some cases, the condition is mild and causes no noticeable symptoms, but in other cases it can lead to permanent liver damage or liver failure. Fatty liver is frequently associated with alcoholic liver disease, but it may also have non-alcoholic causes. In the study, published in the Journal of Clinical Endocrinology & Metabolism, researchers looked at the relationship between fatty liver and diabetes risk in 11,091 adults in Korea. The participants' insulin concentration leve Continue reading >>
How To Reverse Fatty Liver
Two recent studies have come up with some useful information about what it takes to reverse nonalcoholic fatty liver disease. This is a condition where fat accumulates in the liver. It is often considered "benign"--that is not associated with any adverse health effects. But in rare cases it can lead to liver damage and, very rarely, this damage may lead to liver failure. Fatty liver disease is caused by--or found in association with--the taking of certain medications, gastric bypass surgery, high cholesterol, high levels of triglycerides in the blood, malnutrition, metabolic syndrome, obesity, rapid weight loss, toxins and chemicals, such as pesticides, Type 2 diabetes, and Wilson's disease. The drugs reported as causing fatty liver include total parenteral nutrition, methotrexate (Rheumatrex), griseofulvin (Grifulvin V), tamoxifen (Nolvadex), steroids, valproate (Depakote), and amiodarone (Cordarone). However, most people with Type 2 diabetes who develop fatty liver probably develop it because of exposure to the very high triglycerides that result from uncontrolled high sugars. If you are diagnosed with fatty liver, you will probably be told that losing weight will reverse fatty liver, and this appears to be true. The two studies I want to discus here tell us two things: how much weight you have to lose to reverse your fatty liver and what the most effective diet might be for doing that. How Much Weight Loss Reverses Fatty Liver The first study Orlistat for overweight subjects with nonalcoholic steatohepatitis: A randomized, prospective trial. was another drug company supported trial that hoped to prove that the drug, Orlistat, which blocks the digestion of fat would reverse steatohepatitis, which is the term for the inflammatory liver condition that develops in some p Continue reading >>
Non-alcoholic Fatty Liver Disease And Diabetes
Go to: Abstract Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2DM) are common conditions that regularly co-exist and can act synergistically to drive adverse outcomes. The presence of both NAFLD and T2DM increases the likelihood of the development of complications of diabetes (including both macro- and micro- vascular complications) as well as augmenting the risk of more severe NAFLD, including cirrhosis, hepatocellular carcinoma and death. The mainstay of NAFLD management is currently to reduce modifiable metabolic risk. Achieving good glycaemic control and optimising weight loss are pivotal to restricting disease progression. Once cirrhosis has developed, it is necessary to screen for complications and minimise the risk of hepatic decompensation. Therapeutic disease modifying options for patients with NAFLD are currently limited. When diabetes and NAFLD co-exist, there are published data that can help inform the clinician as to the most appropriate oral hypoglycaemic agent or injectable therapy that may improve NAFLD, however most of these data are drawn from observations in retrospective series and there is a paucity of well-designed randomised double blind placebo controlled studies with gold-standard end-points. Furthermore, given the heterogeneity of inclusion criteria and primary outcomes, as well as duration of follow-up, it is difficult to draw robust conclusions that are applicable across the entire spectrum of NAFLD and diabetes. In this review, we have summarised and critically evaluated the available data, with the aim of helping to inform the reader as to the most pertinent issues when managing patients with co-existent NAFLD and T2DM. Keywords: NAFLD, NASH, Diabetes, Insulin resistance, Diabetes complications Continue reading >>
When The Liver Gets Fatty
As Americans have gotten fatter, so have their livers, and some hearts may suffer as a result. There's a fair amount of guesswork to the estimates, but perhaps as many as 20% of American adults have some degree of fatty liver disease, a condition that used to occur almost exclusively in people who drink excessively. The epidemics of obesity and diabetes are to blame. Fatty liver affects between 70% and 90% of people with those conditions, so as obesity and diabetes have become more common, so has fatty liver disease. Fatty liver disease isn't confined to any one group, and there doesn't seem to be pronounced gender differences, but studies suggest that Latinos are disproportionately affected. It's primarily a condition of middle age, although children may get it, too. Fatty liver disease is rapidly becoming more common in Asia, and some research suggests that men in India may be especially susceptible. Plumped-up liver cells The prevailing theory is that the condition gets started because of insulin resistance, which is, in turn, frequently a consequence of obesity and excess fat tissue in the abdomen. When people are insulin resistant, their muscle, fat, and liver cells don't respond normally to insulin, so levels of the hormone — and the blood sugar it ushers into cells — build up in the blood. As a result, the risk of developing diabetes and heart disease increases. But insulin resistance is a complicated metabolic state that also includes an increase in the amount of free fatty acids circulating in the blood. Fatty liver disease occurs when some of those fat molecules accumulate inside liver cells. The presence of those fattened cells can then lead to inflammation in the liver and damage to surrounding liver tissue. Once that happens, if excess alcohol is not in Continue reading >>
Fatty Liver Disease In Diabetes Mellitus
The Warren Alpert School of Medicine, Brown University, Providence, RI 02906, USA Correspondence to: Robert J. Smith, MD. The Warren Alpert School of Medicine, Brown University, 14 Arnold Street, Providence, RI 02906, USA. Email: [email protected]_j_trebor . Received 2014 Oct 24; Accepted 2014 Dec 9. Copyright 2015 Hepatobiliary Surgery and Nutrition. All rights reserved. This article has been cited by other articles in PMC. Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in type 2 diabetes mellitus (T2DM), likely reflecting the frequent occurrence of obesity and insulin resistance in T2DM. NAFLD also can occur in type 1 DM (T1DM), but must be distinguished from the more common glycogen hepatopathy as a cause of hepatomegaly and liver function abnormalities in T1DM. Weight reduction achieved by diet and exercise is effective in preventing and treating NAFLD in obese diabetic subjects. Bariatric surgery also has been shown to reverse NAFLD in T2DM, and recently approved weight loss medications should be evaluated for their impact on the development and progression of NAFLD. There is limited evidence suggesting that specific drugs used for blood glucose control in T2DM [thiazolidinediones (TZDs), glucagon-like peptide-1 (GLP-1) analogs, and dipeptidyl peptidase-4 (DPP-4) inhibitors] and also statins may have a role in preventing or treating NAFLD in patients with diabetes. Keywords: Diabetes mellitus (DM), fatty liver, hepatic steatosis, non-alcoholic fatty liver disease (NAFLD), steatohepatitis Non-alcoholic fatty liver disease (NAFLD) The focus of this review is NAFLD as it relates to diabetes mellitus (DM). As the disease name suggests, NAFLD involves the presence of hepatic steatosis not caused by alcohol intake. When examined histologically, e.g., in a l Continue reading >>
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 >>
Type 2 Diabetes And Fatty Liver Disease
Non-alcoholic fatty liver disease is a group of conditions in which fat builds up in the liver, leading to inflammation of the cells where it is stored and causing the liver to get bigger. It can progress to more serious conditions, including fibrosis and cirrhosis of the liver. Fatty liver disease "is so common. It’s present arguably in a majority of type 2 diabetics,” says Daniel Einhorn, MD, clinical professor of medicine at the University of California, San Diego 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.” Fatty Liver Disease and Type 2 Diabetes: The Connection Diabetes does not cause fatty liver disease. Instead, the two diseases tend to occur in the same people because the same conditions cause both problems. “So, it’s not the diabetes per se. People with diabetes also have obesity and insulin resistance, and so the fatty liver is thought to be part of that,” Dr. Einhorn explains. Einhorn says that most cases of fatty liver disease do not cause any harm. However, since type 2 diabetes and obesity are so common in the United States, fatty liver disease is now a leading cause of end-stage (fatal) liver disease requiring a liver transplant, along with alcohol abuse and hepatitis. Fatty Liver Disease Diagnosis Fatty liver disease has no symptoms. People who are being treated for diabetes will have liver enzyme tests as part of their routine blood work during medical exams. Ninety-nine percent of the cases of fatty liver disease are detected by this test, says Einhorn. In some cases it will be picked up during the physical exam or in imaging studies, like a computed tomography scan of the abdomen or a liver ul Continue reading >>
