Type 2 How to manage my diabetes & liver issues

[cmatanie]

Hello !
I am 62 years old, overweight (110 kgs / 1.90 m) and I take treatment for diabetes since 2012 (but for hypercholesterolaemia since 1995 and for hypertension since 2005).
My main problem with diabetes is the fasting glucose (150 average), the postprandial glucose is normal (120 average) and my last HbA1c is 6.65 (it was before even 5.5).
I decided to write on this forum because of my latest test (FIBROMAX test), which gave me a serious WARNING: I have a severe hepatic steatosis. The results are (range scores between 0-1):
- Fibro Test (evaluates liver fibrosis) - score 0.07 (F0) - no fibrosis
- Acti Test (evaluates activity - inflammation of the liver caused by virus) - score 0.07 (A0) - no activity
- Steato Test (evaluates the accumulation of fat in the liver caused by abnormal metabolism - cholesterol, triglycerides, diabetes, overweight) - score 0.76 (S3) - severe steatosis (> 0.32)
- Nash Test (evaluates the inflammation for metabolic diseases: diabetes, overweight, cholesterol, triglycerides) - score 0.50 (NI) possible inflammation
- Ash Test (evaluates inflammation caused by excess alcohol) - score 0.01 (H0) - no alcoholic inflammation.
Regarding diabetes, I am very interested for the low carb diet but this doesn't work with the steatosis (fat foods good in low carb diet are not good at all in fat liver).
So, WHAT TO DO ?!
I want to manage diabetes and fat liver in the same time, but I don't know how.
Therefore, I will be grateful for any advise or/and experience of other people in a similar situation.
Good health for all !

 

[NoCrbs4Me]

Why do you think dietary fat is bad for your liver?

 

[cmatanie]

Why do you think dietary fat is bad for your liver?

Hi,
First of all, if I don't pay maximal attention, steatosis could be very dangerous because the risk of cirrhosis.
There are no specific medication for steatosis. The best treatment is the diet, a good diet which should take off fat from the liver and not to bring into. Foods like fat diary, chicken with skin, butter, full fat milk, eggs etc. recommended in low carb diet are forbidden for fat liver (in particular the saturated fats).
In steatosis there are two main "drugs": diet and sport.
As sport possibilities are limited for me (I suffered this year two of retinal detachment surgery) it remains for me only the diet.
A diet which must not add extra fat in my liver over the existing one.
I am not a doctor; this is just what I read as recommendations from specialists (doctors) on internet.
On 2-th of November, I have an appointment with a professor hepatologist. I just wait to see what he will tell me about my condition.
It's very, very difficult to find the right way !
Thank you for your reply and all the best for you !

 

[shivles]

Dietary fat isn't stored as fat in the body... hopefully someone will come along who knows more, afraid I don't know about your condition so can't advise

 

[AndBreathe]

Hello !
I am 62 years old, overweight (110 kgs / 1.90 m) and I take treatment for diabetes since 2012 (but for hypercholesterolaemia since 1995 and for hypertension since 2005).
My main problem with diabetes is the fasting glucose (150 average), the postprandial glucose is normal (120 average) and my last HbA1c is 6.65 (it was before even 5.5).
I decided to write on this forum because of my latest test (FIBROMAX test), which gave me a serious WARNING: I have a severe hepatic steatosis. The results are (range scores between 0-1):
- Fibro Test (evaluates liver fibrosis) - score 0.07 (F0) - no fibrosis
- Acti Test (evaluates activity - inflammation of the liver caused by virus) - score 0.07 (A0) - no activity
- Steato Test (evaluates the accumulation of fat in the liver caused by abnormal metabolism - cholesterol, triglycerides, diabetes, overweight) - score 0.76 (S3) - severe steatosis (> 0.32)
- Nash Test (evaluates the inflammation for metabolic diseases: diabetes, overweight, cholesterol, triglycerides) - score 0.50 (NI) possible inflammation
- Ash Test (evaluates inflammation caused by excess alcohol) - score 0.01 (H0) - no alcoholic inflammation.
Regarding diabetes, I am very interested for the low carb diet but this doesn't work with the steatosis (fat foods good in low carb diet are not good at all in fat liver).
So, WHAT TO DO ?!
I want to manage diabetes and fat liver in the same time, but I don't know how.
Therefore, I will be grateful for any advise or/and experience of other people in a similar situation.
Good health for all !

Hello there. I'm sorry you're experiencing this.

To be honest I, personally, would feel very uncomfortable to suggest how you tackle this. I really do think you would be best served by consulting with your Doc who is monitoring your liver, and agree a way forward.

I really do wish you well. It must all be a concern.

 

[Freema]

welcome her cmatanie

you have a lot to worry about so give yourself time to get to know this forum and don´t get scared from contradicting advices.... there are actually a lot of controversy on the subject eaten fat and eaten carbs and on how they do get used in our bodies..
I personally have lovered my triglycerides from getting low in carbs, which is the opposite of what most doctors preach... so thats a riddle....

basically there are many here that experience the same phenomenon and maybe the basics that doctors are taking as a manifestum are and have always been wrong....

like why do people on high fat eating loose so much fat from their bodies , and why do heavy carb eaters become obese...

 

[bulkbiker]

I think you have what we in the UK would call Non Alchoholic Fatty Liver Disease (NAFLD)?
Is that correct?

There is a school of thought that a low carb high fat diet could well help this.. otherwise the Newcastle Diet has been known to reduce fat deposits around the liver and pancreas. Suggest you google Dr Roy Taylor and the Newcastle diet to see how it may work. I have no experience of this as I follow a low carb ketogenic diet but I have lost quite a lot of weight through this way of eating and have much better blood glucose control. I assume this has also helped reduce visceral fat around my internal organs. Unfortunately in the UK there are few ways of measuring this so I can't say for sure. There is also anecdotal evidence that fasting (not eating food) can help with visceral fat reduction.

If you don't have NAFLD then please ignore. I am not a doctor so this is not a diagnosis just a pointer to some things you might find useful to investigate. All of this science is quite new (last 10 years) so your doctor may not be aware of new findings.

 

[NoCrbs4Me]

Hi,
First of all, if I don't pay maximal attention, steatosis could be very dangerous because the risk of cirrhosis.
There are no specific medication for steatosis. The best treatment is the diet, a good diet which should take off fat from the liver and not to bring into. Foods like fat diary, chicken with skin, butter, full fat milk, eggs etc. recommended in low carb diet are forbidden for fat liver (in particular the saturated fats).
In steatosis there are two main "drugs": diet and sport.
As sport possibilities are limited for me (I suffered this year two of retinal detachment surgery) it remains for me only the diet.
A diet which must not add extra fat in my liver over the existing one.
I am not a doctor; this is just what I read as recommendations from specialists (doctors) on internet.
On 2-th of November, I have an appointment with a professor hepatologist. I just wait to see what he will tell me about my condition.
It's very, very difficult to find the right way !
Thank you for your reply and all the best for you !

Ok, so I went to Dr. Google and steatosis is a type of NAFLD. i.e. fatty liver not caused by alcohol over consumption. So it sounds counter intuitive that eating a high fat (and therefore low carb) diet would not make the problem worse. However, it is actually eating too much carbs that cause the fatty liver. Based on my ALT results and a few other markers I believe I reversed my NAFLD on a very low carb / very high fat diet.

Here are a few web pages that you should read:

https://www.dietdoctor.com/low-carb-diet-best-fatty-liver

http://www.precisionnutrition.com/lean-liver-with-low-carb

http://www.drbriffa.com/2011/03/04/...y-effective-for-getting-fat-out-of-the-liver/

http://onlinelibrary.wiley.com/doi/10.1002/hep.21264/pdf

https://www.sciencedaily.com/releases/2011/04/110419003651.htm

http://diabetesupdate.blogspot.ca/2009/03/how-to-reverse-fatty-liver.html

http://www.nature.com/articles/srep16774

 

[daisyduck]

I can only speak from my own experience. After a lifetime of yo-yo dieting (low calorie and low fat) I was diagnosed with Metabolic Syndrome .. which includes type 2 diabetes and non alcoholic fatty liver. My liver readings were off the scale at 185 (not sure what this is, I just remembered the number) A normal liver should read 35 on that scale.
For the last 2 years I have faithfully followed the LCHF diet, and thoroughly enjoyed it.. I lost 2 stones and on my last visit to the liver clinic at the hospital, I was told... Your liver has been consistently normal for a year now so I'm discharging you from this clinic.
LCHF has also lowered my diabetes figures with an Hb reading of 48 last time.. due for another test in November

 

[Lamont D]

I had NAFL and so did the wife!
I was very overweight and nothing that my doctors recommended worked.
My condition dictates that I eat very low carb, my wife has drastically reduced her carbs, but not as dramatic as myself.
However, since doing LCHF and using saturated fats.
Both of our diagnosis of Fatty liver, has returned to normal.

There is no reason why the op should not try a low carb diet, the worst thing he could do is eat low fat products!

 

[Indy51]

There are a number of other threads on the forum about this and here are some recent ones you might want to read:
http://www.diabetes.co.uk/forum/threads/fatty-liver.109468/
http://www.diabetes.co.uk/forum/threads/advice-needed-please.109263/

You might also want to read these blogposts by one of our members who has been researching liver health for many years:
http://hopefulgeranium.blogspot.com.au/2012/10/my-dietary-recommendations-for-liver.html
http://hopefulgeranium.blogspot.com.au/2013/01/fatty-liver-and-its-treatment.html

 

[Indy51]

A diet which must not add extra fat in my liver over the existing one.

I believe you have been seriously mislead about what causes fat to accumulate in the liver - it is not caused by dietary fat.

Endotoxemia caused by SIBO (small intestinal bacterial overgrowth) can also be a problem:
http://onlinelibrary.wiley.com/doi/...ionid=18A51D38750A043D9EA2EB9EF4E7535D.f01t04

(You will find links to other studies on the same subject at the base of this link.)

 

[cmatanie]

Thank you all for the helpful and very friendly answers.
I found in your answers the most important "drug": HOPE !
I will access all recommended links and take all information.
Thanks again and all the best for you all !