Is there a link between fatty liver and high blood sugar?

Q. Two years ago I was told I had a fatty liver. Now, I have high blood glucose levels (146 non-fasting). Could the two be related?

A. Yes, they are related. Fatty liver has become one of the major causes of liver inflammation, cirrhosis, and liver failure. The term to describe this growing epidemic is metabolic-dysfunction associated Sseatotic liver disease (MASLD). Most often, the early stages of fat accumulation in the liver occur without symptoms or adverse consequences.

Sometimes the fat causes liver inflammation, known as metabolic-dysfunction associated steatohepatitis (MASH). In a minority of cases, the inflammation may lead to scarring, cirrhosis, liver failure, and an increased risk of liver cancer.

One of the hallmarks of fatty liver disease is resistance to the sugar-lowering effect of insulin, which also is the cause of type 2 diabetes. This usually occurs in the obese. Obesity is a major factor contributing to MASLD and MASH. Indeed, the increasing obesity rate in develped countries is generally cited as the most important reason for the fatty liver disease epidemic.

Fatty liver is not only associated with diabetes. It is now being recognized as frequently accompanying metabolic syndrome, a worrisome collection of conditions that includes high blood pressure, abdominal obesity, elevated blood triglycerides and low HDL cholesterol (dyslipidemia), and high blood sugars.

Complications of metabolic syndrome include those related to cardiovascular disease (heart attacks, stroke, peripheral vascular disease) and diabetes (loss of vision, nerve damage, kidney failure).

Weight loss and exercise are mainstays of treatment. In addition, there are now effective drug therapies.

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