The link between liver disease and type 2 diabetes

Swedish researchers who examined 212 patients between 1988 and 1993 found that 78 percent of the volunteers developed diabetes or prediabetes, a condition that often leads to type 2 diabetes. They also linked NFLD (Nonalcoholic fatty liver disease), which is sometimes described as a minor condition, to risk of developing end-stage liver disease.

The researchers therefore recommend that lifestyle modifications in all patients with NAFLD should be looked into. Not only would such action reduce the risk of developing type 2 diabetes, intense dietary intervention may also improve liver histology in NFLD.

Treatment options for liver disease

The treatment of liver disease varies, depending on the type of disease. In some cases, treatment involves minimizing or treating complications that may arise due to liver disease.

Liver diseases may be treated with lifestyle changes, such as:
1) Avoiding alcohol or drinking in moderation. Alcohol can damage the liver, so avoiding or minimizing consumption is very important.
2) Avoiding medications that may damage the liver, such as acetaminophen.
3) Eating a well-balanced diet. Liver disease can sometimes impact the body's ability to absorb nutrients so patients must take special care to eat foods high in vitamins and minerals.
4) Following special diets. Patients with ascites and edema, two common complications of liver disease, may follow a low-sodium diet to reduce fluid buildup. Patients with Wilson's disease may be required to avoid foods that are high in copper, such as liver, shellfish, mushrooms and nuts.
5) Exercising regularly. This can help patients maintain a healthy weight.
Liver diseases may also be treated with medications, including:
6) Corticosteroids. A group of anti-inflammatory drugs used to provide relief for inflamed areas of the body by reducing swelling, redness, itching and allergic reactions. They are used to treat autoimmune hepatitis and Budd Chiari syndrome.
7) Interferon. Naturally produced proteins in the immune response that attack viruses and other foreign agents. Interferon is used to treat viral hepatitis.
8) Beta blockers. Medication to treat high blood pressure. A common complication of liver disease is portal hypertension (increased blood pressure in the portal vein).
9) Chelating agent. Medication that binds to copper and helps eliminate it from the body. It is used to treat Wilson's disease.
10) Chemotherapy. This involves using powerful medications to kill cancer cells. Liver cancer is treated with chemotherapy.

What are the symptoms of Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH)?

The symptoms of NAFLD and NASH are identical. They are very bland (not dramatic) and non-specific (can also be observed in other diseases). They can occur at any adult age and, in children, usually appear after 10 years of age. Actually, most patients have no symptoms. They may, however, experience occasional, vague right upper-quadrant abdominal pain (below the rib-cage on the right side). This pain characteristically is dull and aching, without a predictable pattern of occurrence. It is not an intense, sudden, and severe pain, as might occur with, for example, gallstones. The abdominal pain in NAFLD and NASH is thought to be due to the stretching of the liver covering (capsule) when the liver enlarges and/or when there is inflammation in the liver.

Nonalcoholic fatty liver disease - what is it?

Nonalcoholic fatty liver disease (NAFLD) describes a range of conditions that affect people who drink little or no alcohol.

The mildest type is simple fatty liver (steatosis), an accumulation of fat within the liver that usually causes no liver damage. A potentially more serious type, nonalcoholic steatohepatitis (NASH), is associated with liver-damaging inflammation and, sometimes, the formation of fibrous tissue. In some cases, this can progress to either cirrhosis, which causes progressive, irreversible liver scarring, or to liver cancer.

Nonalcoholic fatty liver disease affects more women than men and is found in all age groups, including children. Most often, it's diagnosed in middle-aged people who are overweight or obese, and who may also have diabetes and elevated cholesterol and triglyceride levels (hyperlipidemia).

With the increasing incidence of obesity and diabetes in Western countries, nonalcoholic fatty liver disease has become a growing problem. Although its true prevalence is unknown, some estimates suggest it may already affect as many as one-third of American adults.

Because early-stage nonalcoholic fatty liver disease rarely causes any symptoms, it's usually detected because of abnormal results of liver tests done for unrelated issues. Preferred treatments include weight loss, exercise, improved diabetes control and the use of cholesterol-lowering medications. Research is under way to develop more specific treatments.

Men die faster than women because of their risky lifestyles!

Recent findings by the researchers from Leeds Metropolitan University in England indicate that young men throughout the world have higher death rates than women because of their riskier lifestyles.

Deaths from illnesses such as heart disease, cancer and chronic liver disease rise sharply in 35- to 44-year-olds. The researchers said deaths due to cancer, heart disease and chronic liver disease showed the importance of lifestyle habits such as smoking and alcohol consumption which are known to raise the risk of developing the disorders.

Men tend to have higher chances of developing the majority of cancers. Also, they are dying from it sooner.

What is liver biopsy and why is it done?

Liver biopsy is the removal of a small piece of tissue from the liver using a special needle.
The tissue is examined under a microscope to look for the presence of inflammation or liver damage and hence to determine the cause of the liver disease.
A liver biopsy is normally carried out to:

1) evaluate the cause of jaundice and to help diagnose certain liver diseases such as cirrhosis, hepatitis, and liver tumors.

2) evaluate the cause of abnormal liver function blood test results, especially AST (Aspartate aminotransferase) and ALT (Alanine aminotransferase). Both ALT and AST levels are indicators of possible liver damage.

3) determine the degree of scarring and inflammation as a result of hepatitis or other liver diseases.

4) monitor the effectiveness of a selected treatment for liver disease.

5) measure whether a certain medication, such as cholesterol reducing medication, is producing a negative toxic effect on the liver.

6) monitor the function of a transplanted or donor liver.