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Liver And Diabetes

Liver And Diabetes Type 2, Fix One To Fix The Other!

Liver And Diabetes Type 2, Fix One To Fix The Other!

The world is rediscovering what holistic medicine has held for centuries, that digestive health lies at the core of our well-being. Diabetes is now also being recognized as a digestive and dietary disorder. Digestion and nutrition however does not end with the gut, and is highly dependent on the function of the liver. When I work with patients dealing with fatty or malfunctioning liver, their diabetes improves dramatically too! While the liver carries out hundreds of important tasks for the healthy functioning of the body, here are some ways it directly impacts diabetics: Responds to blood insulin and glucose levels Converts carbohydrates and protein into fats which are stored, then converted back to glucose and released to supply energy Produces bile which breaks down fats during digestion in the small intestine Produces and clears cholesterol which can be excessive in diabetics Metabolizes and activates hormones necessary for proper digestion and metabolism Stores Vitamins A, B12, and D and the minerals copper and iron. These are often deficient in diabetics and can lead to several complications Converts harmful ammonia to urea for excretion through urine; when the liver is overloaded with this task, diabetics can suffer complications of the kidneys Resists infections by producing immune factors and clearing bacteria from the bloodstream; diabetics are more susceptible to infections than non-diabetics What Goes Wrong With The Liver in Diabetics? The liver is an insulin dependent organ, and diabetes is a condition where either the secretion or function of insulin is faulty. Insulin is the hormone, which signals that glucose needs to be absorbed from the bloodstream into the cells. When blood glucose is high like after a meal, so is insulin, and this informs the liver t 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 >>

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 >>

Type 2 Diabetes And Fatty Liver Disease

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 >>

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 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 >>

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 >>

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 >>

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 >>

Dispatch Diabetes: The Importance Of The Liver

Dispatch Diabetes: The Importance Of The Liver

The predominant form of diabetes mellitus, non-insulin dependent diabetes mellitus (NIDDM) or type 2 diabetes, afflicts approximately 4% of the population of the Western world, and its treatment consumes more than 10% of the total National Health Service budget in Britain. The disease is characterised by the failure of sensitive tissues to respond normally to insulin — ‘insulin resistance’. These tissues therefore fail to take up and store glucose, leading to chronically elevated blood glucose (‘hyperglycaemia’). In mild cases, increased insulin production by β cells in the pancreatic islets of Langerhans — leading to ‘hyperinsulinaemia’ — can compensate for the decreased responsiveness to the hormone, but diabetes results when the islets fail [1]. The causes of the disease remain poorly understood, but its predominance amongst overweight individuals — 80% of type 2 diabetics are obese — suggests that dysregulated lipid metabolism may be an important factor. The three major tissues largely responsible for clearing glucose from the blood in healthy individuals — liver, muscle and adipose tissue — all become insulin resistant in NIDDM, but the relative importance of each has been unclear. Two new studies [2,3] shed light on this question. Michael et al.[2] have shown that targeted inactivation of the insulin receptor gene specifically in the liver leads to diabetes-like symptoms in mice. This is an important result, as it demonstrates that insulin has a direct role in regulating liver metabolism. Using two further animal models, Shimomura et al.[3] found that the development of insulin resistance in the liver involves selective inactivation of the capacity of insulin to block hepatic glucose production. On the other hand, the ability of the horm Continue reading >>

Liver And Diabetes. A Vicious Circle

Liver And Diabetes. A Vicious Circle

Go to: INTRODUCTION TYPE 2 DIABETES (T2D) – characterized by hyperglycemia and dyslipidemia caused by islet β-cells being unable to secrete adequate insulin in response to varying degrees of long-standing insulin resistance (IR) in genetically predisposed individuals – poses an enormous burden on modern societies owing to its worldwide explosion, the multi-organ damage and its direct and indirect costs.1 In recent years, the topic “Hepatogenous diabetes” – a definition coined in 1906 to describe the high incidence of diabetes in cirrhotics2 – has gained intense new interest. Clinical observations support that impaired life expectancy of patients with T2D is not only linked to vascular complications and end-stage renal disease but is also associated with cirrhosis and hepatocellular carcinoma (HCC).3 Moreover, insight that non-alcoholic fatty liver disease (NAFLD), the most common liver disorder in many Western countries and an important chronic liver disease in Asia,4 may be a forerunner in the development of systemic IR and T2D5 has gained worldwide attention from basic and clinical investigators alike. Based on these recent clinical observations, we critically reviewed basic and clinical data illustrating the pathways that can lead from NAFLD to the development of T2D via IR, in particular hepatic IR and, conversely, the role that T2D may play in the development of progressive liver disease (i.e. vicious circle). Other hepatological implications of T2D including the risk of bacterial infections in cirrhotic diabetics6,7 are beyond the scope of our review. Continue reading >>

Research Links Fatty Liver Disease To Type 2 Diabetes

Research Links Fatty Liver Disease To Type 2 Diabetes

Research links fatty liver disease to type 2 diabetes Insulin resistance in the liver is a major factor in the development of type 2 diabetes, and it is almost always associated with too much fat in the liver a condition called non-alcoholic fatty liver disease (NAFLD). The question of whether theres a causal link between NAFLD and type 2 diabetes has been unclear. In recent studies, Yale professor of medicine and investigator of the Howard Hughes Medical Institute, Gerald Shulman has identified factors that cause the normal function of insulin in the liver to go awry in NAFLD. A new study pinpoints the final link between NAFLD and the changes in insulin and blood sugar that give rise to type 2 diabetes. In this new study Shulman and his colleagues identified a single amino acid in the insulin receptor that undergoes phosphorylation (a process by which phosphate is added to an amino acid), causing liver insulin resistance in rodent models of NAFLD. We were able to demonstrate the importance of this amino acid in causing liver insulin resistance associated with NAFLD by mutating this threonine amino acid to an alanine, which cannot undergo phosphorylation, and found that we could prevent hepatic insulin resistance despite the presence of fatty liver disease, Shulman said. This latest finding gets scientists a step closer to developing new therapies for type 2 diabetes that target the root molecular cause of insulin resistance, as opposed to virtually all current antidiabetic medications which lower blood glucose concentrations without reversing insulin resistance, he noted. Other authors include Max C. Petersen, Anila K. Madiraju, Brandon M. Gassaway, Michael Marcel, Ali R. Nasiri, Gina Butrico, Melissa J. Marcucci, Dongyan Zhang, Abulizi Abudukadier, Xian-Man Zhang, Wi 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 >>

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 >>

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