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Liver Disease And Diabetes Mellitus

Prevalence And Determinants Of Diabetes Mellitus Among Iranian Patients With Chronic Liver Disease

Prevalence And Determinants Of Diabetes Mellitus Among Iranian Patients With Chronic Liver Disease

Prevalence and determinants of diabetes mellitus among Iranian patients with chronic liver disease Alavian et al; licensee BioMed Central Ltd.2004 Alterations in carbohydrate metabolism are frequently observed in cirrhosis. We conducted this study to define the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in Iranian patients with chronic liver disease (CLD), and explore the factors associated with DM in these patients. One hundred and eighty-five patients with CLD were enrolled into the study. Fasting plasma glucose and two-hour plasma glucose were measured in patients' sera. DM and IGT were diagnosed according to the latest American Diabetes Association criteria. The subjects included 42 inactive HBV carriers with a mean age of 42.2 12.0 years, 102 patients with HBV or HCV chronic hepatitis with a mean age of 41.2 10.9 years, and 41 cirrhotic patients with a mean age of 52.1 11.4 years. DM and IGT were diagnosed in 40 (21.6%) and 21 (11.4%) patients, respectively. Univariate analysis showed that age (P = 0.000), CLD status (P = 0.000), history of hypertension (P = 0.007), family history of DM (P = 0.000), and body mass index (BMI) (P = 0.009) were associated with DM. Using Multivariate analysis, age (OR = 4.7, 95%CI: 1.812.2), family history of DM (OR = 6.6, 95%CI: 2.617.6), chronic hepatitis (OR = 11.6, 95%CI: 2.945.4), and cirrhosis (OR = 6.5, 95%CI: 2.417.4) remained as the factors independently associated with DM. When patients with cirrhosis and chronic hepatitis were analyzed separately, higher Child-Pugh's score in cirrhotic patients (OR = 9.6, 95%CI: 1.088.4) and older age (OR = 7.2, 95%CI: 1.049.1), higher fibrosis score (OR = 59.5, 95%CI: 2.91211.3/ OR = 11.9, 95%CI: 1.0132.2), and higher BMI (OR = 30.3, 95%CI: 3.0306.7) in patie Continue reading >>

The Relationship Between Diabetes Mellitus, Cirrhosis, And Hepatocellular Carcinoma In Patients With Fatty Liver Disease

The Relationship Between Diabetes Mellitus, Cirrhosis, And Hepatocellular Carcinoma In Patients With Fatty Liver Disease

The Relationship between Diabetes Mellitus, Cirrhosis, and Hepatocellular Carcinoma in Patients with Fatty Liver Disease Diabetes mellitus is an independent predictor of cirrhosis and hepatocellular carcinoma (HCC) among patients with fatty liver disease, according to study results presented by lead author Evan Raff, MD, of the department of Internal Medicine, University of Alabama at Birmingham, during a poster session at the 2013 American College of Gastroenterology in San Diego, CA. Diabetes mellitus is among the risk factors for chronic liver disease, along with infection with hepatitis B or C virus, heavy alcohol consumption, and nonalcoholic fatty liver disease. In this retrospective study, to explore the relationship between diabetes and the progression of steatohepatitis, also known as fatty liver disease, researchers looked at medical charts from 2007 to 2011 of patients whose steatohepatitis-related disease was managed at a single tertiary center. The data review included demographics; comorbidities including diabetes mellitus, cirrhosis and complications, and hepatocellular carcinoma; and laboratory, imaging and histology. Other causes of liver disease and excess history of alcohol use were excluded in diagnosis. Patients with and without diabetes mellitus were compared using chi-square and t-tests for categorical and continuous variables, respectively. Independent association of diabetes mellitus with cirrhosis and hepatocellular carcinoma were examined using a logistic regression model and data were reported as an odds ratio with a 95 percent confidence interval. Among the 503 patients with steatohepatitis, 276 had nonalcoholic steatohepatitis. Patients with diabetes compared to those without were more often female, obese, consumed less than one alcoholic Continue reading >>

Liver Disease And Diabetes Mellitus.

Liver Disease And Diabetes Mellitus.

(1)Division of Gastroenterology and Hepatology, Jefferson Medical College, Philadelphia, Pennsylvania, USA. The liver plays an important role in the pathogenesis of NIDDM. More importantly to the clinician is the myriad of situations in which the care of the patientwith diabetes is affected by or causes an effect to the liver. Patients withunderlying diabetes can present with abnormal liver chemistries, which canrepresent findings as benign as hepatic steatosis or as severe as cirrhosis ofthe liver. The medications used to treat diabetes can be potent hepatotoxins.Several primary liver diseases are associated with increased risk of thedevelopment of diabetes. Epidemiologically, there seems to be a correlationbetween diabetes mellitus, the most common endocrinologic disease, and hepatitis C, the leading cause of chronic liver disease in the United States. In themanagement of end-stage liver disease, both cirrhosis and orthotopic livertransplantation promote glucose intolerance and diabetes in a number of patients through various mechanisms including insulin resistance and impaired insulinsecretion. These relationships highlight both the importance of the liver as anendocrine organ and the multisystem aspects of the patient with diabetesmellitus. Continue reading >>

Nonalcoholic Fatty Liver Disease, Diabetes Mellitus And Cardiovascular Disease: Newer Data

Nonalcoholic Fatty Liver Disease, Diabetes Mellitus And Cardiovascular Disease: Newer Data

Nonalcoholic Fatty Liver Disease, Diabetes Mellitus and Cardiovascular Disease: Newer Data 2nd Medical Department and Diabetes Center, NIMTS Hospital, 12 Monis Petraki, 11521 Athens, Greece Received 9 March 2013; Accepted 12 March 2013 Copyright 2013 A. N. Mavrogiannaki and I. N. Migdalis. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Nonalcoholic fatty liver disease (NAFLD) is the most common, chronic liver disease worldwide. Within this spectrum, steatosis alone is apparently benign, while nonalcoholic steatohepatitis may progress to cirrhosis and hepatocellular carcinoma. NAFLD is strongly associated with obesity, dyslipidemia, type 2 diabetes mellitus, and cardiovascular disease. The pathogenesis of hepatic steatosis is not clearly known, but its main characteristics are considered insulin resistance, mitochondrial dysfunction, increased free fatty acids reflux from adipose tissue to the liver, hepatocyte lipotoxicity, stimulation of chronic necroinflammation, and fibrogenic response. With recent advances in technology, advanced imaging techniques provide important information for diagnosis. There is a significant research effort in developing noninvasive monitoring of disease progression to fibrosis and response to therapy with potential novel biomarkers, in order to facilitate diagnosis for the detection of advanced cirrhosis and to minimize the need of liver biopsy. The identification of NAFLD should be sought as part of the routine assessment of type 2 diabetics, as sought the microvascular complications and cardiovascular disease, because it is essential for the early diagnosis and proper inte 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 >>

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 >>

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 >>

The Liver, Liver Disease, And Diabetes Mellitus

The Liver, Liver Disease, And Diabetes Mellitus

The Liver, Liver Disease, and Diabetes Mellitus Albright, Eric S. MD*; Bell, David S. H. MB, FACE† There is an association between diabetes, the liver, and liver disease. Hepatitis C infection is more prevalent in type 2 but not type 1 diabetes. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis are associated with obesity, insulin resistance, and diabetes, and lowering of insulin resistance may modify the progress of these conditions. Hemochromatosis and primary iron overload can damage both the pancreas and the liver and iron levels should be assessed in late onset type 1 diabetic subjects. Type 2 autoimmune hepatitis is associated with type 1 diabetes and other autoimmune endocrinopathies. Liver dysfunction associated with advanced liver disease is associated with insulin resistance, pancreatic beta cell dysfunction, and diabetes, which are reversible in most cases with hepatic transplantation. There is an increased prevalence of cholelithiasis with diabetes caused by the presence of autonomic neuropathy and bile stasis. The incidence of hepatic carcinoma is also increased in diabetic patients probably caused by the increased prevalence of hepatitis C infection. Presently utilized oral hypoglycemic agents are rarely associated with hepatotoxicity. * Describe the relationship between diabetes and hepatitis, non-alcoholic fatty liver, and iron overload. * Discuss the concept of hepatogenous diabetes and its thereapeutic implications. * Distinguish between the adverse effects of different oral hypoglycemic agents on the liver. *Fellow and †Professor of Medicine, Division of Endocrinology and Metabolism, School of Medicine, the University of Alabama at Birmingham, Birmingham, Alabama. This article is the 5th of 36 that will be published in 2003 for wh 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 >>

Fatty Liver Disease In Diabetes Mellitus

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 >>

Current Concepts In Diabetes Mellitus And Chronic Liver Disease: Clinical Outcomes, Hepatitis C Virus Association, And Therapy

Current Concepts In Diabetes Mellitus And Chronic Liver Disease: Clinical Outcomes, Hepatitis C Virus Association, And Therapy

, Volume 61, Issue2 , pp 371380 | Cite as Current Concepts in Diabetes Mellitus and Chronic Liver Disease: Clinical Outcomes, Hepatitis C Virus Association, and Therapy Hereditary type 2 diabetes mellitus is a risk factor for chronic liver disease, and ~30% of patients with liver cirrhosis develop diabetes. Diabetes mellitus has been associated with cirrhotic and non-cirrhotic hepatitis C virus liver infection, can aggravate the course the liver infection, and can induce a lower sustained response to antiviral treatment. Evidences that HCV may induce metabolic and autoimmune disturbances leading to hypobetalipoproteinemia, steatosis, insulin resistance, impaired glucose tolerance, thyroid disease, and gonadal dysfunction have been found. Prospective studies have demonstrated that diabetes increases the risk of liver complications and death in patients with cirrhosis. However, treatment of diabetes in these patients is complex, as antidiabetic drugs can promote hypoglycemia and lactic acidosis. There have been few therapeutic studies evaluating antidiabetic treatments in patients with liver cirrhosis published to date; thus, the optimal treatment for diabetes and the impact of treatment on morbidity and mortality are not clearly known. As numbers of patients with chronic liver disease and diabetes mellitus are increasing, largely because of the global epidemics of obesity and nonalcoholic fatty liver disease, evaluation of treatment options is becoming more important. This review discusses new concepts on hepatogenous diabetes, the diabetes mellitushepatitis C virus association, and clinical implications of diabetes mellitus in patients with chronic liver disease. In addition, the effectiveness and safety of old and new antidiabetic drugs, including incretin-based thera Continue reading >>

Diabetes In Chronic Liver Disease

Diabetes In Chronic Liver Disease

Researchers in Vienna have made a breakthrough with synthetic bile acids in the treatment of primary sclerosing cholangitis. These compounds could feasibly be of use in fatty liver and diabetes – but would require further study. “Bile acids are not only involved in the secretion of bile fluids and fat digestion, but also have hormone-like effects, particularly on the regulation of fat and glucose metabolism in the liver. Researchers at the MedUni Vienna are currently also investigating what role these effects of Nor-Urso [norursodeoxycholic acid] and other bile acid derivatives play in the treatment of fatty liver, diabetes, fat metabolism problems and arteriosclerosis and how they could replace current conventional treatment methods and drugs.” This news is interesting and it reminds us of the strong link between diabetes and the liver. What is this relationship and what are the implications for clinical practice? The liver plays an important role in the regulation of glucose homeostasis. This helps explain why glucose intolerance is a feature or complication of chronic liver disease and cirrhosis. Liver disease associated with diabetes mellitus can be divided into three groups as shown below [1]: 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 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 >>

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 >>

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