What People with Type 2 Diabetes Should Know About Fatty Liver Disease
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Metabolic dysfunction-associated steatotic liver disease, or MASLD, is a new name for what many used to call non-alcoholic fatty liver disease (NAFLD). It happens when too much fat builds up in the liver, not from drinking alcohol, but due to problems like obesity, high blood sugar, and insulin resistance. It’s now recognized as the most common chronic liver disease worldwide.
Why People with Type 2 Diabetes Are at Higher Risk
If you have type 2 diabetes (T2DM), your chances of having MASLD are much higher. In fact, studies show that more than half of people with T2DM also have MASLD. This is because both conditions share common risk factors—especially obesity and insulin resistance.
In a recent study done in Sweden, researchers looked at 308 people with type 2 diabetes who were visiting their regular doctors. They found that 59% of these patients had MASLD. Even more important, about 7% had signs of advanced liver damage, called fibrosis. In rare cases, this can progress to cirrhosis or liver cancer.
Obesity Increases the Risk
Obesity stood out as the most important risk factor in the study. People with a body mass index (BMI) over 30 were eight times more likely to have signs of serious liver damage. The more belly fat they had, the greater their risk. This means that even among people with diabetes, being overweight or obese adds a significant burden to liver health.
Symptoms Are Rare—But Damage Can Be Serious
Most people with MASLD don’t have symptoms in the early stages. That’s why it’s often called a "silent" disease. You may not feel anything is wrong, but fat buildup in the liver can slowly lead to inflammation, scarring, and eventually liver failure.
In the Swedish study, doctors used advanced tools like MRI scans and liver stiffness measurements (Fibroscan) to detect liver problems early—even before symptoms appeared. These tools helped spot people who might be at risk of developing cirrhosis in the future.
What You Can Do to Protect Your Liver
Here are some simple steps anyone with type 2 diabetes can take to lower the risk of MASLD and protect their liver:
1. Watch Your Weight
Keeping your weight in a healthy range is the most effective way to reduce liver fat. If you are overweight, even losing 5–10% of your body weight can significantly improve liver health.
2. Move More
Exercise helps burn fat and improve how your body uses insulin. Aim for at least 30 minutes of physical activity most days of the week—walking, swimming, or cycling all count.
3. Eat Smart
A balanced diet with fewer processed foods and more whole grains, vegetables, and lean proteins is great for your liver. Cut back on sugary drinks and alcohol, which can worsen liver problems.
4. Control Blood Sugar and Cholesterol
Managing your diabetes, blood pressure, and cholesterol levels not only helps your heart but also reduces stress on your liver.
5. Ask About Liver Screening
If you have diabetes—especially if you are overweight—talk to your doctor about liver tests. They may recommend a simple blood test or a scan to check your liver’s condition. Early detection makes a big difference.
What This Study Means for You
The good news is that serious liver disease is not common in people with diabetes who are treated in primary care. In the study, only 1.9% had signs of cirrhosis. But that doesn't mean you should ignore your liver. MASLD can sneak up quietly, and when combined with diabetes, the risks increase.
The most important takeaway is this: you can take control. Healthy lifestyle changes make a real difference. If you manage your weight, eat well, stay active, and get regular check-ups, you’re doing the best thing possible for your liver—and your overall health.