7 Effects of Diabetes on Liver Health

Dr. Tashko, a diabetes specialist, prioritizes liver health, addressing fatty liver disease and NASH, during treatment for comprehensive diabetes management.

Introduction – Holistic Diabetes Care in Montgomery County, Maryland

As a diabetes specialist practicing in Montgomery County, Maryland, I focus on providing tailored care to individuals with diabetes, emphasizing its impact on liver health. My approach is comprehensive and evidence-based.

Conveniently situated in Rockville, my practice offers both virtual and in-person services. We extend support to nearby areas such as Chevy Chase, Bethesda, North Bethesda, Potomac, North Potomac, Gaithersburg, Germantown, Frederick, Silver Spring, Northern Virginia, Howard County, Anne Arundel, and the Eastern Shore of Maryland, ensuring comprehensive care. My aim is to improve the health and quality of life in our community by offering personalized therapies for managing diabetes and its effects on liver health.

Without further ado, let us explore the key aspects of diabetes-related liver conditions, including non-alcoholic fatty liver disease (NAFLD), anon-alcoholic steatohepatitis (NASH), and more.

1. Non-Alcoholic Fatty Liver Disease (NAFLD)

NAFLD is a condition where fat builds up in the liver without alcohol use. It is common in people with type 2 diabetes and insulin resistance. Insulin resistance leads to higher blood sugar levels, causing the liver to store more fat. This can result in inflammation and liver damage, progressing to non-alcoholic steatohepatitis (NASH) or cirrhosis. Managing blood sugar levels, losing weight, and adopting a healthy lifestyle can help reduce the risk and impact of NAFLD in those with type 2 diabetes.

2. Non-Alcoholic Steatohepatitis (NASH)

NASH is a severe form of nonalcoholic fatty liver disease (NAFLD). It involves liver inflammation and damage due to fat buildup. NASH is common in people with type 2 diabetes and insulin resistance. These conditions promote fat accumulation in the liver, triggering inflammation and fibrosis. Patients with NASH often have obesity, high blood pressure, and abnormal cholesterol levels. Managing diabetes and insulin resistance through diet, exercise, and medication can help reduce liver fat and inflammation, potentially preventing progression to cirrhosis or liver cancer.

3. Impaired Glucose Regulation

In diabetes, the liver contributes to impaired glucose regulation by producing too much glucose. This happens because insulin, which normally signals the liver to stop glucose production, is less effective due to insulin resistance. Additionally, the liver fails to store glucose properly as glycogen. This excess glucose enters the bloodstream, raising blood sugar levels. The liver also releases glucose inconsistently, adding to the erratic blood sugar levels seen in diabetes.

4. Increased Risk of Hypoglycemia

In diabetes, the liver plays a crucial role in regulating blood sugar levels. When blood sugar drops too low, the liver usually releases stored glucose to bring it back to normal. However, in diabetes, this process might not work well due to insulin issues or liver dysfunction. As a result, the liver might not release enough glucose, leading to hypoglycemia, a condition of low blood sugar.

5. Impaired Lipid Metabolism

In diabetes, the liver struggles to regulate lipids, leading to problems with how fats are processed in the body. High blood sugar triggers the liver to make more lipids, contributing to high triglyceride levels and non-HDL cholesterol. This imbalance can worsen insulin resistance, making diabetes harder to manage. Additionally, excess lipids in the liver can cause non-alcoholic fatty liver disease (NAFLD) as mentioned above, a common complication of diabetes.

6. Risk of Cirrhosis and Liver Failure

Diabetes heightens the risk of cirrhosis and liver failure by causing fat accumulation in the liver (NAFLD). Over time, NAFLD can progress to inflammation (NASH) and scarring of the liver, leading to cirrhosis. Diabetes also contributes to insulin resistance, which further aggravates liver damage. Moreover, diabetes often coexists with other risk factors for liver disease, like obesity and high cholesterol, compounding the risk. Tight control of blood sugar levels, weight management, and lifestyle modifications can help reduce the likelihood of liver complications in individuals with diabetes.

7. Risk of Liver Cancer (Hepatocellular Carcinoma)

Diabetes and insulin resistance can heighten the risk of hepatocellular carcinoma. When insulin levels are consistently high, it can stimulate cell growth in the liver, increasing the likelihood of cancerous changes. Additionally, diabetes can lead to fatty liver disease (NAFLD) and inflammation (NASH), further elevating the risk of hepatocellular carcinoma. Monitoring blood sugar levels and managing diabetes effectively through lifestyle changes and medications can help lower this risk.


It is important for patients with diabetes to manage their insulin resistance and hyperglycemia effectively through lifestyle changes, medication management, and regular medical check-ups. Controlling blood sugar levels, maintaining a healthy weight, and addressing other risk factors like high blood pressure and high cholesterol can help reduce the risk of liver complications associated with diabetes. Consulting with an endocrinologist or diabetes specialist is key for managing both diabetes and its potential liver consequences.

Dr. Tashko