Type 2 & Fatty Liver - questions

RyJames said:

Hi all,

I’ve just had my most recent blood tests done and I was a little disappointed my Hba1c had raised to 44 from 40 this time last year although I’ve been very strict although the GP reassured me I’m still on track (I take metformin along with an almost 0 calorie diet).

However they also performed a liver function blood test (I was diagnosed with fatty liver in 2020) and my Alt came back ever so slightly raised at 49 and should be below 45.

Just wondering if there’s any correlation between the two increases as I’m aware fatty liver is quite common in type 2’s.

Thanks in advance

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Putting it ridiculously simply: The sugars that you can't burn off, are stored as fat on the liver. That's a really, really short version of a longer story, but it explains why so many T2's have non-alcoholic fatty liver disease, and potentially, obesity.

So when you say you're on zero calories.... You'd be faring better with more calories and fewer carbs. The calories aren't the problem for someone with metabolic syndrome, the carbs are. Reduce those, and you reduce the fats packed onto your liver, as reduce your blood glucose level. It's win-win all over the place, and you should be able to get your numbers our of the prediabetic range, back into the normal range, right-quick. https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html should help.

Good luck!
Jo

RyJames said:

Apologies I’ve edited the post now. I meant to say almost 0 carbs! Although I am on a very low calorie diet in conjunction.

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Very low calorie and low carb aren't sustainable when combined, as they basically mean a crash diet... Your body does need something to run on, some nutrients etc. Try to find something that you can keep up until Kingdome Come, basically?

@RyJames that last post sounded more lecture-y than I meant it to. Just concerned you might be becoming deficient in certain vitamins and minerals: been there, done that, not pleasant and can take a while to come back from.

Just, you know. Take care of yourself.

RyJames said:

Hi all,

I’ve just had my most recent blood tests done and I was a little disappointed my Hba1c had raised to 44 from 40 this time last year although I’ve been very strict although the GP reassured me I’m still on track (I take metformin along with an almost 0 carb diet).

However they also performed a liver function blood test (I was diagnosed with fatty liver in 2020) and my Alt came back ever so slightly raised at 49 and should be below 45.

Just wondering if there’s any correlation between the two increases as I’m aware fatty liver is quite common in type 2’s.

Thanks in advance

Click to expand...

According to Prof Roy Taylor a fatty liver is the root cause of Type 2 - all his theories on the subject are summarized in this long interview - Link

He has three main theories:
- Losing a lot of weight reduces liver fat, reducing insulin resistance in the liver and lowering blood triglyceride levels, which leads to reduced fasting blood glucose levels and ectopic fat deposition in other organs including the pancreas, which can partially reverse the effects of lipid toxicity (fat poisoning) of pancreatic beta cells, which can lead to a partial recovery of insulin secretion, if it is impaired. The part about liver fat causing insulin resistance and raising fasting blood glucose levels is quite well proven at this point. On top of Taylor's research there is evidence from experiments in attempting to prevent fatty liver disease with medication for example, which found that keeping fat out of the liver prevents rises in insulin resistance and resulting elevated fasting blood glucose levels, at least in mice - Link
- The 'Twin Cycle Hypothesis' for how Type 2 occurs - Taylor asserts this is how all cases of Type 2 occur. I don't buy that, but it's a plausible and as yet not-disproven explanation for how *most* cases diagnosed as Type 2 occur in my opinion. It this theory is entirely correct then every Type 2 has a fatty liver at time of diagnosis.
- The 'Personal Fat Threshold' theory for how a fatty liver occurs in the first place. Maybe there's something in this, but my own reading on the risk factors for Non Alcoholic Fatty Liver Disease (NAFLD) indicates to me that there are lots of ways for fat to accumulate in the liver other than reaching a genetic body fat threshold.

So yes - to the best of my limited understanding your HbA1c going up while on an extremely low carb diet, in conjunction with an increase with ALT, is very probably due to an increase in liver fat levels.

I was NAFL when I got my T2 with raised LFT and My T2 Scores.

As I lost weight cut out alcohol and carbs both came down.
From point of diagnosis with very fatty liver, it took 3 years to reverse that to mildly fatty, to a now almost 5 years non fatty liver.

NAFL in remission.

Could be worth asking for a US on your liver and see how it's fairing up, even with low LFTs a fatty liver and other organs will impact you BG.