A recent study — the DiaFib-Liver Study, published in The Lancet Regional Health — found that one in four adults with type 2 diabetes in India has liver fibrosis, and about one in 20 already shows signs consistent with probable cirrhosis. The researchers argue that fibrosis, rather than simple fat accumulation in the liver, should be the primary focus of routine assessment in diabetes care and call for fibrosis screening to be integrated into diabetes management programs.
Diabetes and liver disease are tightly linked through shared metabolic disturbances. In type 2 diabetes, the body’s tissues cannot use insulin effectively, raising blood sugar levels. Excess sugar is often converted into fat and deposited in the liver, a condition known as steatosis. Over time, these metabolic changes can set off a chain of damage that moves beyond fat storage.
Insulin resistance also drives fat cells to release more free fatty acids into the bloodstream, which accumulate in the liver and worsen steatosis. Fat-laden liver cells produce free radicals and trigger oxidative stress, which damages cells and sparks inflammation. When inflammation and cell injury persist, the condition can progress to Metabolic Dysfunction-Associated Steatohepatitis (MASH), a more severe and damaging form of fatty liver disease.
The liver responds to ongoing injury by laying down scar tissue, a process called fibrosis. Progressive fibrosis can eventually lead to cirrhosis, leaving the liver scarred and less able to function. Long-standing inflammation and cirrhosis also raise the risk of hepatocellular carcinoma, a primary liver cancer. Diabetes frequently occurs as part of metabolic syndrome-alongside obesity, high blood pressure and abnormal lipids-which further amplifies liver disease risk.
Preventive measures for people with diabetes focus on early detection and controlling metabolic drivers. Regular liver function tests, including measurements of ALT and AST, can help detect early dysfunction. Even modest weight loss of 5–10 percent has been shown to improve liver health. A balanced diet rich in fruits, vegetables, whole grains, lean proteins and healthy fats-and low in high-fructose sweeteners and saturated fat-can reduce liver stress. Regular physical activity, targeting at least 150 minutes of moderate exercise per week, improves insulin sensitivity and aids weight control.
Tight blood glucose control through diet, activity and appropriate medications-especially agents that address insulin resistance-can lower liver disease risk. Alcohol should be limited or avoided by people with diabetes or known liver disease. Vaccination against hepatitis A and B is recommended for those with liver disease, and management of blood pressure and cholesterol remains important to protect the liver. Patients should consult their doctor or a liver specialist for personalized screening and treatment decisions.
Original Source: https://www.ndtv.com/health/diabetes-and-fatty-liver-diseases-how-insulin-resistance-increase-liver-disease-risk-11302097#publisher=newsstand
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Publish Date: 2026-04-02 17:21:00
