Fatty Liver Disease

Fatty liver disease (also known as non-alcoholic fatty liver disease) is used as a generic term to encompass those conditions that cause fat to build up within the liver.

Fatty liver disease is particularly dangerous for people with diabetes because it increases the risk of cardiovascular issues such as heart attack and stroke.

Fatty liver disease is common and more likely amongst people who are obese or overweight. Those people with diabetes who fall into this category are therefore at a greater risk of fatty liver disease, and this section examines the condition and how to avoid it.

I have diabetes, how do I avoid fatty liver disease?

Lowering the risk of non-alcoholic fatty liver disease is generally a matter of gradual weight loss and maintaining regular exercise. This also helps to lower the risk of cardiovascular problems.

How does the liver help?

The liver helps to store fuel (glycogen) made from sugars, breaking it down and releasing it to the bloodstream.

Fats and proteins are processed and toxins are removed by the liver. Bile, which breaks down the fat in foods, is also created by the liver.

Is non-alcoholic fatty liver disease always the same for people with diabetes?

Non-alcoholic fatty liver disease (NAFLD) can be broken down into four different stages. Simple fatty liver means excess fat and usually doesn’t cause harm.

Steatohepatitis (NASH) means excess fat in the liver is inflamed. Fibrosis occurs when scar tissues form. Cirrhosis happens when normal liver tissues is replaced by fibrosis, and can affect the structure and function of the liver, even leading to liver failure.

Isn’t liver disease down to alcohol?

Another form of fatty liver can occur amongst people who drink lots of alcohol, but this is a separate condition.

Will my NAFLD progress to NASH?

Only a minority of people develop NASH, and only a minority of these proceed to cirrhosis.

Is NAFLD common amongst people with diabetes?

Risk factors for non-alcoholic fatty liver disease include type 2 diabetes.

Type 1 diabetes does not increase the risk of developing NAFLD. Being overweight and obese increases risks of NAFLD. Age, hypertension and certain drugs are all NAFLD risk factors.

Does having liver disease increase risk of developing diabetes?

People who have NAFLD have a greater risk of developing type 2 diabetes and cardiovascular diseases.

What are the symptoms of non-alcoholic fatty liver disease?

Usually, there are no symptoms. Sometimes a nagging pain in the abdomen can be felt, and NASH may cause a feeling of tiredness.

How can I diagnose NAFLD?

No simple tests can diagnose NAFLD, but liver function tests can help you to understand the health of your liver. Abnormal LFTs may indicate the presence of fatty liver disease, and doctors can conduct other tests to rule out liver problems. A scan of the liver may also reveal the likelihood of NAFLD.

How is non-alcoholic fatty liver disease treated?

Usually weight loss through diet and exercise can reduce the amount of fat in the liver. In some cases, obesity surgery is prescribed.

Treatment of linked conditions, especially cardiovascular disease, may require lifestyle intervention.

This can include stopping smoking, keeping weight down, regularly exercising and eating a healthy balanced diet.

Avoiding alcohol is also good guidance, because moderate amounts of alcohol can make NAFLD worse.

How serious is fatty liver disease?

About 2 in every 100 people with simple fatty liver develop cirrhosis over a 15-20 year period.
About 12 in every 100 people with NASH develop cirrhosis over 8 years.

Most people with NAFLD therefore do not develop serious liver disease. However, cardiovascular disease is extremely serious, and reducing risk factors should be a major goal for people with diabetes.