HTF Blog: Liver disease

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Diabetes Wake-Up Call: Liver Screening Tools Help Battle Obesity-Related Diseases

Observed annually on the fourth Tuesday in March, Diabetes Alert Day is a one-day “wake-up call” that focuses on the seriousness of diabetes and the importance of understanding the risk.

This year, Healthy Truckers Foundation is highlighting the link between liver disease and diabetes and urging individuals and communities to help raise awareness about the impact of diabetes – especially for professional drivers. Diabetes is one of the leading causes of disability and death in the United States. It affects about 30.3 million Americans or about 9.4 percent of the U.S. population. Nearly 1 in 4 adults living with diabetes, or 7.2 million Americans, are unaware that they have the disease.

Our goal is to bring greater awareness to the relationship between nonalcoholic fatty liver disease (NAFLD), an asymptomatic condition characterized by elevated levels of fat in the liver, and diabetes. As a common complication of Type 2 diabetes and obesity, NAFLD can be an overlooked comorbidity.

The good news is that a growing number of primary care providers and liver specialists recognize that NAFLD has become the most common chronic liver disease in developed countries.

Diabetes and NAFLD/NASH

The more severe form of NAFLD, nonalcoholic steatohepatitis (NASH), is associated with necrosis, inflammation and fibrosis. NASH has few symptoms and often normal plasma aminotransferases. Nevertheless, it is a leading cause of end-stage liver disease and hepatocellular carcinoma (HCC), and significantly increases the risk of developing Type 2 diabetes.

In a recent study, NAFLD was found in 50% of patients with Type 2 diabetes who had normal aminotransferase levels. The prevalence of NAFLD was 56% in patients with obesity and 36% in patients without obesity. Increasing body mass index was significantly associated with a greater prevalence of NAFLD (P=0.001). In addition, a higher plasma hemoglobin A1C was significantly associated with a higher prevalence of NAFLD (P=0.01) and an increased liver triglyceride accumulation (P=0.005).

Adla Tessier, M.D., La Maestra Family Clinics, says, “The prevalence of NAFLD has increased in parallel with the epidemics of Type 2 diabetes and obesity. More than 90 percent of the patients we see in our diabetic clinic have associated metabolic syndrome, insulin resistance and are overweight.  Data show that weight loss and glycemic control can help slow or even reverse progression of NASH in the early stages of the disease.”

FibroScan®: Assessing Liver Health

To help clinicians combat the spike in NAFLD among patients with Type 2 diabetes, we point to  FibroScan®, a non-invasive, painless and quick examination, designed to quantify the stiffness of the liver via proprietary and patented technique of VCTE™, a medical non-imaging modality that quantifies the stiffness of liver tissue. FibroScan® also measures CAP™, a quantification estimate of liver fat. Together these measures provide consistent information about the presence or status of disease, which is important in the diagnosis and monitoring of NAFLD.

In recognition of Diabetes Alert Day, we are pleased to announce the growing availability of FibroScan® for diagnosis and monitoring as a tool that can make a critical difference in the lives of individuals with diabetes who also face chronic liver disease.

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