Dr. Jitendra Singh
The ominous risk of diabetic effect on heart, eyes and kidneys is well known. As a result, physicians constantly strive to guard against it, screen it and check it. Quite rightly so! But, in the process, there could be a possibility of overlooking the diabetes damage being suffered by other important organs is like, for example, the liver. And it is this aspect which the new insights into diabetes management seek to focus on.
Fatty liver is a common and a relatively harmless finding in diabetes. However, what needs to be periodically screened for and guarded against is the possibility of Diabetes enhancing the risk of chronic liver disease and sometimes even liver cancer.
Two Fold Risk
Diabetes has been found to be an important risk factor for causing chronic liver disease including hepatocellular carcinoma which is a malignant condition. Some of the studies from reputed centers like Houstan Medical Center Texas have reported that individuals with Diabetes could be at about two-fold greater risk of developing what is described as “Chronic non-alcoholic liver disease”. And that too in those who had diabetes but no prior recorded history of liver disease.
The increased risk to develop liver disease seems independent of age, gender, ethnicity or co-existing illnesses and is found to be higher in those who have been having Diabetes for 10 years or more.
Periodic Liver tests recommended.
Several earlier studies had also reported a statistically significant positive association between Diabetes and liver cancer. However, for a long time , it remained unclear whether diabetes actually preceded the development of significant liver disease. Later evidence, nevertheless, established that long-standing Diabetes is followed by the development of liver disease and liver cancer thus suggesting a causative role for Diabetes.
In the light of above inputs, regular periodic testing of liver function particularly the liver enzymes is recommended for all diabetics. Every individual with Diabetes should be advised Liver Function Tests (LFTs) early in the course of Diabetes and then periodically thereafter. An Ultrasound of abdomen to screen liver should also be undertaken as a routine investigation in every Diabetic.
The message, in a nutshell, for both the Diabetologist as well as the Diabetic is not to overlook or ignore the potential effect of diabetes on liver.
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