Is glucose central to the three great epidemics; obesity, diabetes, and non-alcoholic fatty liver?

[Southport GP]

Hi,
I hear that a hospital consultant (gastroenterologist) in the South Lancs area has told GP's not to do GGT blood tests! Other liver blood tests can be done as normal.

With the current epidemic of liver disease and diabetes this is a retrograde step and perhaps one would find it difficult to comprehend.

I understand GGT is a relatively low cost blood test so that cannot be the reason.

I hope this is not a national policy.
regards
D.

This is not national policy and I am puzzled as to why he might do this ?

Certainly in my own practice 24% of liver function tests done come back as abnormal.
If the only result of these tests is to confuse and worry patients while frightening GPs into doing many unnecessary and expensive gastroenterology referrals then there is little point in doing them. However many patients appreciate these test results as an early warning and as a result make lifestyle improvement to have fewer carbs or alcohol
Sometimes a raised GGT result is a distress signal from a liver unable to cope with some medications so it would be a shame not to heed this warning .
Sometimes I never find the cause of the abnormal test.

Finally we GPs are independent practitioners so can usually ask for any blood tests we think are important for the care of our patients.

Cheers D.

 

[lindisfel]

Hi Dr. Unwin,
Thanks for your response.
I don't think it would put the GP I know off doing GGT blood test either.
regards
Derek

This is not national policy and I am puzzled as to why he might do this ?

Certainly in my own practice 24% of liver function tests done come back as abnormal.
If the only result of these tests is to confuse and worry patients while frightening GPs into doing many unnecessary and expensive gastroenterology referrals then there is little point in doing them. However many patients appreciate these test results as an early warning and as a result make lifestyle improvement to have fewer carbs or alcohol
Sometimes a raised GGT result is a distress signal from a liver unable to cope with some medications so it would be a shame not to heed this warning .
Sometimes I never find the cause of the abnormal test.

Finally we GPs are independent practitioners so can usually ask for any blood tests we think are important for the care of our patients.

Cheers D.

 

[Sean01]

I wonder if glucose is central to the three great epidemics of our time; obesity, diabetes, and non-alcoholic fatty liver (20% of the population)

With The Department of Obesity and Endocrinology, Liverpool University and Prof Feinman of New York we have researched a practical response to try and help some of the folk with abnormal liver function, many of whom have T2D by using a lower carb, higher fat diet; published here http://bit.ly/1NYsS6x

The work has taken three years and was nearly fully funded by us in the practice. Please pass it on if you feel it has any merit.

Essentially when the liver glucose stores are full any more dietary glucose has to be cleared somehow-so the liver converts it to fat – fatty liver. Prof Taylor feels this fat and similar fat in the pancreas explains why (I love this quote.)

‘Before diagnosis of Type 2 diabetes, there is a long silent scream from the liver.

As the fat interferes with the normal functioning of both organs.

The good news is this process could be reversible and may possibly in part help explain how reducing the glucose in the diet can improve liver function, insulin sensitivity and obesity.

Certainly the patients in the study had the GGT liver blood test improve by an average of 47%. Reading this it looks a huge claim- makes me nervous. Anyway read the paper for more, but bear in mind I am not an academic only a GP and it’s just a pilot study.
Excellent article and I agree. (retired body builder and graduate Biologist). The problems started when we switched from fats to carbs back in the 70's(?) The 5 a day campaign made it worse. Most people will reach for sugary fruit rather than green vegetables. We are a nation of sugar junkies. Diabetes will be the biggest threat health wise and financially to the NHS. I will follow you on twitter.
Thanks to my wife Jen I can now be followed on twitter @lowcarbGP

 

[Time2Change]

I believe Fatty Liver is a major factor in most T2D ..... I stumbled on a chap called Dr Berg on youtube recently and he has a couple of great clips around fatty liver and how to reverse it ... I am now taking cruciferous shakes everyday !!!

 

[kokhongw]

Perhaps we have overlooked that chronically elevated insulin is also a major contributing factor in T2D. That is where high fats and intermittent fasting are remarkable effective for lowering both insulin AND glucose levels?