Last week we discussed the role of insulin resistance in the development of type 2 diabetes.  Interestingly it can also develop in type 1 diabetes over time, and especially if the diet is high in fats.

From today we want to start with a few articles on some of the complications of diabetes, and see how lifestyle factors can reverse these.

ALSO READ : Turning the Tide – Diabetes – treat the cause to fix the symptoms

Diabetes and Fatty Liver disease

The first one to talk about is fatty liver disease (also called non-alcoholic fatty liver disease).  This affects almost 30% of the American population and is set to become another epidemic around the world. It is the most common cause of liver failure in the USA, and is far more common than liver failure from alcohol excess or Hepatitis B infections.

What is driving the epidemic?

It is especially fast foods – sugary drinks and fatty foods – particularly the high intake of animal fats and cholesterol.

Here is a very helpful short video that explains the cause of the epidemic.

If you look up complications of type 2 diabetes, you will often find fatty liver as a complication. Although fatty liver disease can occur in the absence of diabetes, it is often associated with diabetes development because the main factor causing insulin resistance is excess fat intake, resulting in deposits of fat in both muscle and liver cells.  This is especially true with high intake of saturated animal fat, including cholesterol, but actually any excess fat intake can contribute to insulin resistance, and thus also fatty liver.  So, diabetes doesn’t cause fatty liver, as much as excess dietary fat causes both fatty liver, as well as insulin resistance and thus diabetes type 2.

How do we diagnose fatty liver?

Symptoms: In most cases it has no symptoms.  Sometimes it can present with discomfort in the upper right side of the abdomen, and be a cause of fatigue and nausea.  In more severe cases it can result in jaundice.

Examination: Your doctor may be able to palpate enlargement of the liver on examination of the abdomen. 

A common association with fatty liver is increased abdominal girth.  A waist circumference of more than 102 cm in men and 88 cm in women (measured at the level of the umbilicus) is strongly associated with increased abdominal fat, fatty liver disease and higher risk of diabetes, heart disease and certain cancers.

Blood tests:  Aspartate amino transferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT).  These enzymes are normally found inside liver cells, but with damage they are spilled into the blood and are thus elevated when measured.  These tests are often performed on a regular liver screening blood test.

Other diagnostic interventions: include ultrasound, MRI and liver biopsy – the latter does have some risks.

Consequences of prolonged fatty liver disease

Over a period of time the liver becomes damaged and scarred, leading to cirrhosis and eventual liver failure.

What can you do to reverse fatty liver?

The most important intervention is lifestyle change – cutting way back on sugary and fatty foods, particularly fast foods, sugary beverages, fatty meats, braais, cheesy pizzas, alcoholic drinks, sweets, cakes, biscuits, pastries and pies.

ALSO READ : Turning the Tide – Which carbs are not the enemy?

Increase the consumption of whole foods like fruits, vegetables, whole grains, legumes, and a small amount of nuts and seeds.

Exercise is very helpful in burning up the intracellular fat globules in the liver, and in muscles.

Another helpful intervention is medically supervised water fasting.

Certain anti-diabetic medications are also known to reduce insulin resistance and fatty liver disease.

All of these interventions can also have a profound positive effect on diabetes as well, so you will be dealing with both issues together.

Next week we will deal with diabetes and cardiovascular disease.

You can take control of your health destiny by evaluating your present lifestyle, and adopting changes that can improve your health.

Until next week,

Dave Glass

David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.

He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology.

An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.

He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.

HAVE YOUR SAY

Like our Facebook page, follow us on Twitter and Instagram