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
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.