Diabetes & Your Liver: The Overlooked Connection

November is Diabetes Awareness Month - a time to focus on understanding, preventing, and managing one of the most common chronic conditions in the world. Most people associate diabetes with high blood sugar and insulin resistance, which over time can damage the eyes, kidneys, nerves and heart.

But there’s another vital organ affected by the disease: your liver. The relationship between diabetes and liver health is often overlooked, yet the two are closely linked.

The Liver Connection

Your liver plays a crucial role in maintaining balanced blood sugar levels. It stores glucose (sugar) in the form of glycogen and releases it into the bloodstream when your body needs energy—especially between meals or during exercise.

In healthy individuals, insulin acts as a signal to help the liver know when to store or release glucose. When diabetes develops, this communication system becomes disrupted.

In type 2 diabetes, insulin resistance prevents the liver from responding properly to insulin’s signals. As a result, the liver may release too much glucose into the blood, worsening high blood sugar levels.

Over time, this cycle of insulin resistance, elevated blood sugar, and fat buildup can take a serious toll on liver health.

Liver Complications

One of the most common liver complications linked to diabetes is nonalcoholic fatty liver disease (NAFLD)*, a condition where excess fat accumulates in the liver. Studies suggest that up to 70% of people with type 2 diabetes may have some form of NAFLD.

In its early stages, fatty liver may cause no symptoms at all. As fat and inflammation increase, it can progress to nonalcoholic steatohepatitis (NASH)*, fibrosis, and even cirrhosis. All of which are serious liver conditions that can lead to liver failure or liver cancer.

The connection doesn’t end there. People with type 2 diabetes are also at higher risk for hepatitis C, hemochromatosis (iron overload), and drug-induced liver injury due to the increased use of medications to manage blood sugar and related conditions.

Similarly, people with chronic liver disease are more likely to develop insulin resistance, creating a two-way relationship that can complicate both conditions.

NALFD is now known as MASLD (metabolic dysfunction-associated steatotic liver disease)

NASH is now known as MASH (metabolic dysfunction associated steatohepatitis)