What Every Diabetic Should Know About Liver Disease

Did you know that diabetics are 50% more likely to develop liver disease? Particularly fatty liver disease.

Fatty liver disease is incredibly common in overweight people; nearly everyone with excess weight on their abdomen has some degree of fatty liver. Type 2 diabetics are prone to carrying excess weight on their abdomen, but even slim diabetics often have a fatty liver.

It is well known that diabetes increases the risk of kidney disease, nerve damage, blood vessel damage, infections, blindness, erectile problems and heart disease, but you may not realise diabetes has terrible effects on the liver. You can’t see or feel the effects it’s having on your liver until liver cells become damaged.

According to Gillian Booth, MD, MSc, of St. Michael’s Hospital in Toronto, in a population-based study, newly diagnosed diabetes was linked with a near doubling in the rate of cirrhosis, liver failure or liver transplant compared with non-diabetics.  Clearly these are significant findings that should be taken seriously.

Insulin resistance (syndrome X) is the driving force behind the development of fatty liver.  Insulin resistance is a forerunner to type 2 diabetes.  If the insulin resistance becomes severe enough, a person usually develops type 2 diabetes.  Type 1 diabetes usually develops in childhood, although by the time they are in their mid 30s, most type 1 diabetics have developed insulin resistance as well, and they face the same risks as type 2 diabetics when they get older.

People with insulin resistance have high levels of insulin in their bloodstream.  Insulin signals to your liver to manufacture fat, especially triglycerides and cholesterol.  This promotes the accumulation of fat inside the liver, inside other organs, inside arteries and as general body fat stores.  As insulin levels become higher and higher, insulin loses its ability to control blood sugar levels.  Therefore the blood sugar level creeps upwards, eventually getting high enough to qualify as diabetes.

Whenever you eat carbohydrate containing foods, your body digests them and breaks them down into glucose.  All foods contain some carbohydrate except animal protein such as meat, fish, chicken, eggs as well as pure fat like oil and butter.  Glucose isn’t of much use to you in your bloodstream; you need it inside your cells where it can be used for energy.  It is the job of insulin to transport the glucose from your bloodstream into your cells.

People with insulin resistance lose the ability to do that, therefore they crave foods high in carbohydrate (such as sugar, bread, pasta) and feel weak, hungry or irritable if they don’t eat these foods regularly.  Because their body cannot use carbohydrate efficiently for energy, these carbohydrate rich foods are converted into fat instead.  The vast majority of diabetics have a fatty liver. You do not need to be overweight to have a fatty liver; the condition is very common in slim people.

If you have diabetes, you are probably well aware that you require regular blood tests to check on the health of your kidneys and your heart.  You probably have regular eye exams and foot examinations; however it is not standard practice to offer diabetics liver exams.  This is very unfortunate because there is very little that can be offered to a person who has developed severe liver disease other than liver transplantation.

The authors of this study recommend that every diabetic has a blood test and ultrasound to check on the health of their liver annually.  The blood test would check the levels of liver enzymes (to test for inflammation and damage to liver cells) and the ultrasound would check for the presence of fat accumulation.  A CT scan and liver biopsy may be required in cases of advanced liver disease.

What you can do to protect your liver

Firstly it is important to realise that the closer you are to a healthy body weight, and the closer to normal your blood sugar level is, the better the health of your liver.  Diabetes promotes abdominal weight gain, and this is the most dangerous body part to store excess fat.  Fat doesn’t just sit under your skin; it actually gets inside your abdominal cavity, in amongst your organs and then starts to infiltrate various organs such as the liver and pancreas.

Our book called Diabetes Type 2: You can reverse it Naturally contains a lower carbohydrate, higher protein eating plan specifically designed for diabetics.

Other recommendations to protect your liver:

  • Avoid sugar and flour and the foods and drinks that contain them.  Also avoid vegetable oil and every food that contains it.  The only safe vegetable oil to consume is cold pressed olive oil, cold pressed macadamia nut or avocado oil and organic coconut oil.  In experiments done on rats, when they are fed sugar and vegetable oil, they develop a fatty liver. Avoid cottonseed oil, as it is particularly toxic to the liver. Many cafes cook food in cottonseed oil.
  • Increase your intake of vegetables, particularly raw vegetables.  Your liver desperately needs the antioxidants, vitamins and minerals found abundantly in these foods.  Most people eat nowhere near enough vegetables.  Ideally you would have seven serves of vegetables per day; a serve is half a cup of chopped vegetables, or one cup of leafy vegetables.  Adding a raw vegetable juice to your day will give you even more benefits. You will find juice recipes for the liver and for diabetes in my book Raw Juices Can Save Your Life.
  • Reduce your consumption of alcohol.  If you are overweight and have a mild fatty liver, alcohol will speed the progression of fatty liver and greatly increase the risk of cirrhosis.
  • Berberine is a plant extract that helps to remedy the metabolic dysfunction in type 2 diabetics. It helps to reverse syndrome X, assists with weight loss from the torso and helps to normalize cholesterol and triglycerides. The benefits of berberine rival those of prescription medication for type 2 diabetes.
  • Obtain sufficient minerals required for blood sugar control, these are primarily chromium and magnesium.  It is very difficult to obtain enough of these minerals through modern diets and some medication increases the loss of these minerals from your body, particularly diuretics.  Chromium and magnesium work best when combined with the herbs Gymnema and bitter melon, such as in Glicemic Balance capsules.
  • Take a liver tonic containing an effective dose of St Mary’s thistle.  St Mary’s thistle helps to protect liver cells from damage and can even help to regenerate damaged liver cells.  If you have some degree of liver dysfunction we strongly recommend you take a liver tonic long term, such as Livatone Plus.
  • Exercise regularly.  Exercise helps your body to burn fat from the areas you can see, such as your thighs and triceps, but also helps to clear fat from areas you can’t see, such as your liver, arteries and other organs.
  • Take a fish oil supplement.  Fish oil is extremely high in omega 3 fats and it is impossible to get enough omega 3 from your diet to have a beneficial effect on your liver.  Fish oil is a strong natural anti-inflammatory and helps to heal damaged liver cell membranes.


Porepa L, et al. Newly diagnosed diabetes mellitus as a risk factor for serious liver disease.  CMAJ 2010

These statements have not been evaluated by the FDA and are not designed to diagnose, treat or cure any disease.