If you live with type 2 diabetes, you're more at risk of fatty liver disease. Both conditions are linked to your metabolism. Your metabolism is how your body stores and uses energy.
It's a good idea to talk to your diabetes healthcare team about your risk of liver disease. It's a myth that only people who drink lots of alcohol get liver disease, anyone can develop the condition.
The full name for fatty liver disease is metabolic dysfunction-associated steatotic liver disease or MASLD. Until recently it was called non-alcohol related fatty liver disease or NAFLD. You might hear any of these names being used.
What is fatty liver disease?
Fatty liver disease is caused by having too much fat stored in your liver. This can cause inflammation which can lead to liver damage. Over time liver damage can lead to scars called fibrosis. Having serious scarring in your liver is called cirrhosis.
People can live for years with cirrhosis, but if your liver keeps getting more scarred it can stop working properly. Your liver is like your body's factory and does lots of important jobs that keep you alive and well. So, if it starts to fail, it can quickly cause serious problems.
Liver disease and cirrhosis aren't only caused by alcohol, you can get them even if you never drink alcohol. You are more likely to get fatty liver disease if you:
- Live with type 2 diabetes
- Live with obesity or overweight
- Have a large waist measurement
- Follow an unhealthy diet
- Get little or no physical activity and exercise
- Spend long periods of time sitting (sedentary). This does not include sleeping.
Your liver is really good at repairing itself. So, liver disease usually develops slowly over time. This means by finding it early, there's a chance to stop, slow down or even reverse any damage. But there often aren't any symptoms to tell you your liver is being damaged. This is why testing is so important.
You can read more about fatty liver disease on the British Liver Trust website.
How could this affect me?
Around two-thirds of people living with type 2 diabetes also have fatty liver disease, and about a third have some scarring in their liver.
Living with both conditions can increase your likelihood of experiencing diabetes complications and of developing more serious liver disease. For example, having both type 2 diabetes and fatty liver disease further increases your risk of heart disease. So, it's important to find out if you could be affected.
The conditions are similar which means the treatment can be too. The main treatments for fatty liver disease are:
- A healthy, balanced diet
- Being physically active
- Keeping to a healthy weight
Keeping to a healthy weight is easier said than done. But you're not alone in this, there's support out there to help - a good first step is to ask your healthcare team for health and advice.
Low-calorie diets, like the 'soup-and-shake' diet, can also help you lose weight and improve the health of your liver. But it's important to speak to your healthcare team first to find out if this approach is safe for you.
At the moment, there aren't any medicines available in the UK or fatty liver disease itself. Researchers are testing medicines, including some used to treat type 2 diabetes to see if they can treat fatty liver disease.
What tests should I have?
Talk to your healthcare team about fatty liver disease and whether you could be at risk. Ask to be referred for tests to check for any signs of liver damage or scarring (fibrosis). Routine liver blood tests, sometimes called liver function tests, can't rule out fatty liver disease. You should have extra tests to check for liver scarring.
There are different tests your doctor can use. You might have one test or a combination. These are the most commonly used tests:
- Enhanced liver fibrosis (ELF) test. This is a blood test that measures 3 chemicals in the blood that are markers for scarring. That means their levels go up when you have scarring.
- Fibrosis-4 (FIB-4) test. This uses 4 numbers to calculate a risk score for liver scarring. It includes your age, plus blood test results for your platelet count, and the levels of 2 chemicals that are linked to liver damage.
- FibroScan. This is a scan that uses vibrations for the level of scarring in your liver. It's similar to having an ultrasound.
As well as tests, the doctor will ask questions about your medical history and daily habits. This helps them understand whether you have any other risks for liver disease. This will help them to make any diagnosis. It's important to understand the cause of a person's liver disease as this is linked to how it's treated.
You can read more about tests for liver disease on the British Liver Trust website.
More information and support
The British Liver Trust are here to help when it comes to liver disease. They have online and printed information as well as support services to help you get advice, meet other people with liver disease, or just talk to someone who understands.
Call their nurse helpline on 0800 652 7330.
Read more about fatty liver disease on their website.
Find out more about support groups and other services.
