Fatty liver increases all cause mortality in type two diabetics

Adapted from BMJ 17 Feb 2024

A Korean study of more than 7 million people determined at baseline if they had type two diabetes or not, and whether they had a normal liver, a mild fatty liver or severe fatty liver. They then followed them up for over 20 years to see what effects were seen on all cause mortality, or cardiovascular disease (myocardial infarction or ischaemic stroke).

In the non diabetic population 21.2% had mild fatty liver and 10.2% had severe fatty liver. In the type two diabetes population, 34% had mild fatty liver disease and 26.73% had severe fatty liver disease.

They found that even mild fatty liver disease increased cardiovascular mortality and all cause mortality in type two diabetics. As the degree of fatty liver increased, so did the rates of death for all cause and cardiovascular disease.

6.5% of the studied Korean population had type two diabetes. Weight loss through lifestyle modifications (diet and exercise) remains the cornerstone of management of type two diabetes, fatty liver and cardiovascular disease, but is difficult to achieve and even harder to maintain.

Newer weight loss drugs have shown promise in treating type two diabetes and in reducing fatty liver, but are expensive and may need to be continued for many years.