Skip to main content

Diabetes and the Liver

Image
By
One could wonder why in diabetes, a condition in which the blood sugar concentration in the blood goes up, need we worry about the liver? Or for that matter, even take the blood sugar reports seriously at all.

Doctors have begun to realize that the elevated blood sugar value is only the tip of the iceberg. Patients with type 2 diabetes, the common form of the disease that occurs in adulthood, often go on to develop problems with several other organs of the body, such as kidneys,

brain, blood vessels, heart, feet and the liver.

At the root of the problem in Type 2 Diabetes, is the observation that contrary to intuitive logic, the blood levels of insulin in this condition is increased!

Insulin resistance (IR) as its is called brings with it several changes in the body such as thickening of the basement membrane, the floor on which cells of all organs of the body are lined up and pushes up fatty acids in blood circulation, that then gets deposited in the liver and blood vessels.

Fatty liver is seen in two-third of diabetics. It usually has no clear symptoms in the early stages often getting recognised during investigations for abnormal readings on liver function tests (AST, ALT or GGT levels in blood) or during an ultrasound examination.

It is however not an innocuous condition. Research shows that patients with extra fat in their livers die earlier, that is, their lives are shorter than their fat-free counterparts.

What happens to people with Fatty Liver? Some of them go on to develop a state of weakness of the liver called Liver Cirrhosis. In this condition, liver cells die insidiously and are replaced by scar tissue. The organ gradually starts functioning poorly, sometimes causing swelling of feet or retention of water in the abdomen. The veins in the food pipe can get engorged and rupture, causing blood vomiting.

When the liver gets very weak due to Liver Cirrhosis, transplantation of the diseased organ is sometimes required. This condition is getting so common that it makes up around a third of all causes of liver transplantation.

Another recent finding that research has shown up is that patients with diabetes and fatty liver are at increased risk of developing liver cancer. They often come silently or are incidentally picked up on imaging tests, but progress aggressively over few months. Scientists are debating whether all type 2 diabetics with excess fat in their liver should be monitored periodically with CT scans or MRI scans to watch for early liver cancer.

Diabetes therefore is a condition of not merely increased blood levels of sugar. Although it has a genetic basis, its severity and outcome is decided by how we eat, and exercise, and get our periodic checks done to ensure our organs are keeping healthy.

Liver is a large organ with lots of reserve, but it is wise not to ignore it in diabetes. 

Comments

Post a Comment

Popular posts from this blog

Food Fads in Liver Disorders

By
In an attempt at trying to do well to those they love, spouses and parents often enforce diets on patients of liver diseases that often turn out to be detrimental. The commonest food fad is pale insipid boiled cabbage being doled out to nauseous patients suffering from hepatitis that makes them puke even more.  The liver, in a way, is a buzzing manufacturing unit that requires lots of energy to keep its multiple functions going. And it derives all this from the food we eat. During disease, such as during an attack of jaundice, when many of the liver cells get killed, the liver attemptsdamage control by trying to regenerate quickly. For its cells to multiply however, it requires a generous supply of energy that comes from carbohydrates, and protein, the building block for its cells and tissues. Boiled green vegetables unfortunately have neither of these. Hence the situation often progresses to that of a starved liver unable to recuperate due to cut-off food supply.
2 comments
Read more

Bad Dreams, Disturbed Sleep

By
  A good night’s sleep, so essential to rest your body and mind, and restore ‘energy” and vitality, is becoming a casualty for many these days. Last week a 58 year old lady complained that she woke up with a startle in the middle of the night dreaming of “drugs”, something she had never been exposed to all her life. Another reported a nightmare in which he felt someone was “strangulating” him by tightening something around his neck, till he woke up feeling choked! Yet another reported dreaming that he was in an ICU of a hospital with PPE draped figures surrounding his bed while he was being prepared to be hooked to a ventilator. Bad dreams can be disturbing to say the least. One wakes up with a startle or in sweat, feeling disturbed and uneasy, and feeling drained. The mood in the morning is usually uneasy and snappy. Creative thinking has usually gone for a toss…postponed to yet another day when one feels more cheerful and positive.   Several factors could be contributing to “
1 comment
Read more

The Doctor’s Dress

By
The familiar white coat worn by physicians as their distinctive dress for over 100 years, has started generating  murmurs  of controversy. It is not uncommon to find the blood pressure to be higher when measured by a white-coat-wearing-doctor in the hospital or clinic than the readings obtained at home by relatives.  This is due to the anxiety that the white coat and the hospital setting evokes in patients, and has been termed “White Coat Hypertension”. Mature clinicians often routinely subtract a few points from these measurements when entering records in case charts or calculating the dose of anti-hypertensive medications to be prescribed. The white coat scares children too.  Kids often express their dislike for this dress by crying and screaming and by denying access to their bellies or chest for examination by paediatricians in this attire. Many pediatricians across the world have folded up their white coats and taken to informal colourful dressing to get closer to thei
2 comments
Read more