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Diabetes UPSC NOTE

 What is the connection between diabetes and the liver?

  • The liver is a store house or a factory for various products and one of them is glucose

  • When there is excess glucose in the body, it gets deposited in the liver as glycogen

  • The excess fat in the blood circulation (triglycerides and free fatty acids) also gets deposited in the liver and this is called ‘Fatty Liver’.

  • Over 50% of people with type 2 diabetes have some degree of fatty liver

  • When there is excess fat in the liver, this leads to a condition called ‘Hepatic Insulin Resistance’. 

  • What this means is that the body’s insulin cannot function properly

  • Also the action of insulin in the liver is considerably reduced. 

  • This leads to increased release of glucose from the liver, which is referred to as ‘Hepatic Glucose Production’. 

  • Increase in the fasting plasma glucose is mainly attributed to this increased hepatic glucose production.

  • The relationship between fatty liver and type 2 diabetes is bidirectional

  • Thus, fatty liver can lead to type 2 diabetes and type 2 diabetes can promote fatty liver

  • If both obesity and diabetes are present, over 80% of such individuals will have fatty liver

  • While fatty liver by itself is not dangerous, very often it leads to inflammation of the liver, a condition known as Non-alcoholic ‘Steatohepatitis’ or NASH

  • Up to this stage it is probably reversible. However, at the next stage, it can progress to cirrhosis of the liver which is irreversible and can be fatal

  • Some people with cirrhosis of the liver even go on to develop hepatocellular carcinoma (HCC). 

  • The link between diabetes, fatty liver, cirrhosis and HCC is being increasingly recognized.

  • Today non-alcoholic fatty liver (NAFLD) is recognised as a complication of diabetes and also as a cause of diabetes. 

Metabolic dysfunction-associated fatty liver disease’ (MAFLD)

  • Recently the close association of metabolic syndrome (a term used to refer to a combination of diabetes, hypertension and central obesity) and NAFLD has been recognised and internationally.

  •  The term NALFD is being replaced with ‘Metabolic dysfunction-associated fatty liver disease’ (MAFLD).

How can we treat MAFLD?

  • The best way is lifestyle modification.

  • A healthy diet consisting of less calories, carbohydrate and fat but more vegetable protein and fibre is a powerful tool to lose weight and treat excess fat in the liver. 

  • Adequate exercise along with yoga can also help shed extra kilograms. 

  • It has been shown in research trials, that by profound calorie restriction .

  • This can lead to reversal of diabetes and other metabolic abnormalities within a few days or weeks, even before significant weight loss is achieved.

  • We also have specific medicines which can help reduce fatty liver and reverse liver changes. 

  • Important to identify early changes in the liver to prevent progression to its more advanced stages like cirrhosis or carcinoma

  • Apart from check ups for eyes, kidneys, heart, feet and nerves, the liver should also be included in the annual work up of all individuals with diabetes. 

  • November 14 will be observed across the world as Diabetes Day

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Learnerz IAS | Concept oriented UPSC Classes in Malayalam: Diabetes UPSC NOTE
Diabetes UPSC NOTE
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