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Can Liver Disease Be Caused By Diabetes?

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 & 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 >>

How Does Diabetes Affect The Liver?

How Does Diabetes Affect The Liver?

Liver disease may occur as a result of diabetes, and the reverse is true as well. Non-alcoholic liver disease may also be caused by obesity, protein deficiency, HIV infection and exposure to toxic chemicals. Drugs such as corticosteroids, tamoxifen and estrogens also may damage the liver. Diabetics who have concurrent hepatitis C infection are at high risk of complications. Video of the Day The liver plays a role in glucose regulation. Glucose is transported from the intestines to the liver, which stores it as glycogen or uses it for fuel. Insulin receptors in fat, liver, and muscle cells facilitate the use of glucose. Insulin regulates the entry of glucose into tissues and promotes glycogen storage. Insulin is metabolized in the liver, where it promotes the production of glycogen, protein, cholesterol, and triglycerides and stimulates the formation of low density lipoproteins, or LDL, which transport cholesterol into the arteries. In diabetes, excessive output of glucose by the liver contributes to elevated fasting blood sugars. Fat accumulation in the liver may be linked to excess glycogen, which is common among diabetics. Fatty deposits may be due to the increased transport of fat to the liver from the intestines or to decreased removal of fat from the liver. The condition occurs secondary to obesity as well as diabetes, but the exact reasons are unknown. The National Institute of Diabetes and Digestive and Kidney Disease reports that 10 to 20 percent of Americans have fatty liver. Diagnosis may depend on blood work, CT scan or ultrasound imaging and biopsy. Although there may be no symptoms, an enlarged liver and enzyme abnormalities are characteristic of fatty liver. The condition may also cause abdominal pain, nausea and vomiting, or--rarely--fluid accumulation ar 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 >>

Liver Cirrhosis And Diabetes: Risk Factors, Pathophysiology, Clinical Implications And Management

Liver Cirrhosis And Diabetes: Risk Factors, Pathophysiology, Clinical Implications And Management

Go to: About 30% of patients with cirrhosis have diabetes mellitus (DM). Nowadays, it is a matter for debate whether type 2 DM in the absence of obesity and hypertriglyceridemia may be a risk factor for chronic liver disease. DM, which develops as a complication of cirrhosis, is known as “hepatogenous diabetes”. Insulin resistance in muscular and adipose tissues and hyperinsulinemia seem to be the pathophysiologic bases of diabetes in liver disease. An impaired response of the islet β-cells of the pancreas and hepatic insulin resistance are also contributory factors. Non-alcoholic fatty liver disease, alcoholic cirrhosis, chronic hepatitis C (CHC) and hemochromatosis are more frequently associated with DM. Insulin resistance increases the failure of the response to treatment in patients with CHC and enhances progression of fibrosis. DM in cirrhotic patients may be subclinical. Hepatogenous diabetes is clinically different from that of type 2 DM, since it is less frequently associated with microangiopathy and patients more frequently suffer complications of cirrhosis. DM increases the mortality of cirrhotic patients. Treatment of the diabetes is complex due to liver damage and hepatotoxicity of oral hypoglycemic drugs. This manuscript will review evidence that exists in relation to: type 2 DM alone or as part of the metabolic syndrome in the development of liver disease; factors involved in the genesis of hepatogenous diabetes; the impact of DM on the clinical outcome of liver disease; the management of DM in cirrhotic patients and the role of DM as a risk factor for the occurrence and exacerbation of hepatocellular carcinoma. Keywords: Insulin resistance, Type 2 diabetes mellitus, Liver cirrhosis, Hepatocellular carcinoma, Chronic hepatitis C Continue reading >>

Diabetes And Nonalcoholic Fatty Liver Disease: A Pathogenic Duo

Diabetes And Nonalcoholic Fatty Liver Disease: A Pathogenic Duo

Limitation of Use: The safety and efficacy of Humulin R U-500 used in combination with other insulins has not been determined. The safety and efficacy of Humulin R U-500 delivered by continuous subcutaneous infusion has not been determined. For the Humulin R U-500 vial, particular attention should be paid to the 20-mL vial size, prominent “U-500” and warning statements on the vial label, and distinctive coloring on the vial and carton. Dosing errors have occurred when Humulin R U-500 was administered with syringes other than a U-500 insulin syringe. Patients should be prescribed U-500 syringes for use with Humulin R U-500 vials. The dose of Humulin R U-500 should always be expressed in units of insulin. DO NOT transfer Humulin R U-500 from the Humulin R U-500 KwikPen into any syringe for administration. Overdose and severe hypoglycemia can occur. Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in insulin, manufacturer, type, or method of administration should be made cautiously and only under medical supervision and the frequency of blood glucose monitoring should be increased. Hypoglycemia: Hypoglycemia is the most common adverse reaction associated with insulin, including Humulin R U-500. Severe hypoglycemia can cause seizures, may be life-threatening, or cause death. Severe hypoglycemia may develop as long as 18 to 24 hours after an injection of Humulin R U-500. Hypoglycemia can impair concentration ability and reaction time; this may place an individual and others at risk in situations where these abilities are important, such as driving or operating other machinery. Early warning symptoms of hypoglycemia may be less pronounced in patients with longstanding diabetes, in patients with diabetic nerve disease, in patients using medications th Continue reading >>

Can Diabetes Cause Cirrhosis?

Can Diabetes Cause Cirrhosis?

Can Diabetes Cause Complications to the Liver and Kidneys Can diabetes cause liver and kidney issues? Uncontrolled diabetes is known to cause diabetic nephropathy. But liver disease? Find out. Overview Can diabetes cause liver and kidney issues? This is a common question among diabetics. By definition, diabetes is a disease characterized by high levels of blood sugar due to the lack of insulin in the body or to the body’s inability to respond to the presence of insulin. Insulin is the hormone that allows the sugar to get to the cells and provide them with energy. Uncontrolled diabetes can frequently result in many complications which cause damage to important body organs like the liver, kidneys, eyes and nerves. It can also result in other conditions like heart disease and stroke. It can lead to diabetic ketoacidosis as the body fats are being used for energy. Diabetic ketoacidosis, if not managed early, can become life threatening. Other complications of diabetes are skin and mouth infections, bone problems, like osteoporosis, and foot damage. Diabetes may put a person at risk of developing liver and kidney disease. Some of the more common liver and kidney complications of diabetes are non-alcoholic cirrhosis and diabetic nephropathy. Non-alcoholic cirrhosis Cirrhosis, or the scarring of the liver, is often associated with alcohol abuse, but it can also be a complication of diabetes. Non-alcoholic cirrhosis is a general term for the scarring of the liver not due to excess alcohol consumption. In this condition, the liver is hardened is unable to function normally.High levels of sugar and cholesterol in the blood, as well as obesity, are considered contributing factors to the development of non-alcoholic liver cirrhosis in diabetic patients. Use of some drugs for the 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 >>

Diabetes During Pregnancy Linked To Liver Disease Later In Life

Diabetes During Pregnancy Linked To Liver Disease Later In Life

(Reuters Health) - Women who develop diabetes while pregnant may be at elevated risk of also developing a dangerous build up of fat in their livers when they reach middle age, according to a new analysis. The common risk factor for both gestational diabetes and non-alcoholic fatty liver disease, researchers say, is trouble making or using the hormone insulin to manage blood sugar, known as insulin resistance. “We hope that early identification can promote healthy lifestyle changes that prevent or slow disease progression,” said lead author Dr. Veeral Ajmera of the University of California, San Francisco. “Pregnancy stresses the body in many ways, one of which is the ability to manage blood sugar,” Ajmera said by email. “During pregnancy a woman’s body becomes more resistant to insulin, which is the hormone required to decrease the blood sugar.” Insulin resistance is also “central to development of non-alcoholic fatty liver disease,” which affects 20 percent to 30 percent of adults in the western world, the study team writes in The American Journal of Gastroenterology. Non-alcoholic fatty liver disease is the most common chronic liver disease in the United States. Fatty liver disease is often diagnosed later in life, Ajmera told Reuters Health. So the researchers used long-term data to see if diabetes during pregnancy made a woman more likely to develop fatty liver disease 25 years later. The researchers analyzed information about 1,115 black and white women recruited between 1985-1986 in four cities across the United States who gave birth to at least one child. The participants did not have diabetes before becoming pregnant and the study excluded people who had liver issues related to alcohol, HIV, hepatitis or medications. At the start of the study, w Continue reading >>

Metformin, The Liver, And Diabetes

Metformin, The Liver, And Diabetes

Most people think diabetes comes from pancreas damage, due to autoimmune problems or insulin resistance. But for many people diagnosed “Type 2,” the big problems are in the liver. What are these problems, and what can we do about them? First, some basic physiology you may already know. The liver is one of the most complicated organs in the body, and possibly the least understood. It plays a huge role in handling sugars and starches, making sure our bodies have enough fuel to function. When there’s a lot of sugar in the system, it stores some of the excess in a storage form of carbohydrate called glycogen. When blood sugar levels get low, as in times of hunger or at night, it converts some of the glycogen to glucose and makes it available for the body to use. Easy to say, but how does the liver know what to do and when to do it? Scientists have found a “molecular switch” called CRTC2 that controls this process. When the CRTC2 switch is on, the liver pours sugar into the system. When there’s enough sugar circulating, CRTC2 should be turned off. The turnoff signal is thought to be insulin. This may be an oversimplification, though. According to Salk Institute researchers quoted on RxPG news, “In many patients with type II diabetes, CRTC2 no longer responds to rising insulin levels, and as a result, the liver acts like a sugar factory on overtime, churning out glucose [day and night], even when blood sugar levels are high.” Because of this, the “average” person with Type 2 diabetes has three times the normal rate of glucose production by the liver, according to a Diabetes Care article. Diabetes Self-Management reader Jim Snell brought the whole “leaky liver” phenomenon to my attention. He has frequently posted here about his own struggles with soarin 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 >>

Fatty Liver May Be Linked To Diabetes Risk

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 >>

What Everyone With Diabetes Should Know About Liver Disease

What Everyone With Diabetes Should Know About Liver Disease

It’s well known that diabetes increases the risk of kidney disease, nerve damage, blood vessel damage, infections, blindness and heart disease, but you may not realize diabetes can have profound effects on the liver as well. Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease that affects up to one-third of the entire adult population in industrialized countries. And if you have type 2 diabetes mellitus -- the diabetes in which your own insulin does not work properly, compounded by increasingly less and less insulin made in the pancreas — you are even more at risk of having NAFLD. Recognition and description of NAFLD dates back to only 30 years ago, when scientists noted the appearance of liver tissue that reminded them of alcoholic hepatitis, with findings resembling chronic alcohol use, but in individuals that had no history of alcohol abuse or even alcohol intake. Although once thought uncommon, today’s medical professionals recognize that if one was looking for 20 patients with NAFLD, given the high prevalence of the disease, this number could likely be recruited within one day in a lobby of a hotel. NAFLD is an umbrella term that includes several subtypes of liver cell appearances and clinically distinct conditions, including fatty liver (referred to as NAFL or steatosis hepatis) and more serious steatohepatitis (NASH), with or without fibrosis (scarring), that can progress to liver cirrhosis and, in a few cases, to liver cancer. Precisely differentiating between these different liver conditions can be challenging: usually a liver biopsy is needed to look at the actual appearance of the liver cells, the fat content of the liver, and any scarring or other specific tissue changes. Hepatic steatosis is de-fined as liver fat content above 5.5 per Continue reading >>

Mechanisms Of Diabetes-induced Liver Damage

Mechanisms Of Diabetes-induced Liver Damage

Go to: Abstract Diabetes mellitus is a non-communicable disease that occurs in both developed and developing countries. This metabolic disease affects all systems in the body, including the liver. Hyperglycaemia, mainly caused by insulin resistance, affects the metabolism of lipids, carbohydrates and proteins and can lead to non-alcoholic fatty liver disease, which can further progress to non-alcoholic steatohepatitis, cirrhosis and, finally, hepatocellular carcinomas. The underlying mechanism of diabetes that contributes to liver damage is the combination of increased oxidative stress and an aberrant inflammatory response; this activates the transcription of pro-apoptotic genes and damages hepatocytes. Significant involvement of pro-inflammatory cytokines—including interleukin (IL)-1β, IL-6 and tumour necrosis factor-α—exacerbates the accumulation of oxidative damage products in the liver, such as malondialdehyde, fluorescent pigments and conjugated dienes. This review summarises the biochemical, histological and macromolecular changes that contribute to oxidative liver damage among diabetic individuals. Keywords: Diabetes Mellitus, Liver Diseases, Inflammation, Oxidative Stress Diabetes mellitus (dm) is a major global public health problem with an escalating incidence and prevalence, particularly in developing and newly industrialised countries.1 Concern regarding this chronic disease is focused on serious DM-related complications which can affect multiple vital organ systems, thereby leading to more severe and irreversible pathological conditions such as nephropathy, retinopathy, vasculopathy, neuropathy and cardiovascular diseases, as well as hepatopathy.2 Research indicates that DM is associated with a number of liver abnormalities, such as abnormal glycogen Continue reading >>

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