Ordinarily, the liver will not produce fat during or immediately after eating. This is because the insulin release triggered by the food acts on the liver to stop it. However, in conditions of ‘insulin resistance’ (often a part of type 2 diabetes), the liver doesn’t act on the insulin stop-signal. Some of the fats that are produced find their way into the blood, but others remain in the liver – compounding the problem.
This condition is known as non-alcoholic fatty liver disease (NAFLD) and is thought to affect up to 30% of people in the UK. It is far more common in individuals who are overweight or obese. As such, weight loss by any means will help, although exercise seems to have an additional benefit and is strongly encouraged.
Drugs that act on the glucagon-like peptide 1 receptor and also the ‘thiazolidinedione’ class of drugs (Pioglitazone, also known as Actos) have demonstrated beneficial effects in patients with diabetes and NAFLD but there is no accepted pharmacological treatment for these patients.
A new class of medication generating particular interest is the ‘SGLT2 inhibitor’. These medications lead to glucose loss is the urine and so reduce the total calorie load. A recent trial has shown that they can lead to fat loss from the liver – interestingly even without major weight loss. Further, confirmatory studies are required but this may prove to be a useful addition to diet and exercise
If you would like to discuss your diabetes, lipids and or metabolism and how to improve your cardiovascular, liver and general health, then do make contact with the team here at LondonSwissMedical. Dr Martin Whyte is a Consultant Diabetologist and Physician with LondonSwissMedical and King's College Hospital and Senior Lecturer in Metabolism at the University of Surrey. He is an expert in the metabolic abnormalities underlying #NAFLD, non-alcoholic steatohepatitis (#NASH) and in the management of patients with NAFLD, NASH, type 2 diabetes, metabolic dyslipidaemia/ hypercholesterolaemia, hypertension and obesity and overweight.