"The negative impact of diabetes mellitus is well recognized, yet little is known about the effect of this disease on the liver, an organ susceptible to nonalcoholic fatty liver disease related to insulin resistance," write Liane Porepa, MD, from the University of Toronto in Ontario, Canada, and colleagues.
The investigators used administrative health databases for the province of Ontario from 1994 to 2006 to identify 438,069 adults with newly diagnosed diabetes. A comparison group of 2,059,708 individuals without known diabetes were matched 5:1 to exposed persons by birth year, sex, and local health region. Persons with preexisting liver or alcohol-related disease were excluded. The main study endpoint was incident serious liver disease, defined as Cirrhosis, liver failure and its complications, or receipt of a liver transplant.
Among persons with newly diagnosed Diabetes, the incidence rate of serious liver disease was 8.19 per 10,000 person-years vs 4.17 per 10,000 person-years among those without diabetes, yielding an unadjusted hazard ratio (HR) of 1.92. After adjustment for age, income, urban residence, healthcare utilization, and preexisting comorbid conditions (hypertension, dyslipidemia, obesity, and cardiovascular disease), the HR was 1.77 (95% CI, 1.68 - 1.86). The authors write, "Whether the increased risk of liver damage reflects nonalcoholic fatty liver disease or direct glycemic injury of the liver remains to be determined."
Whatever may be the underlying mechanism of the diabetic hepatopathy, the most natural way to protect the liver from most damaging influences would call for the use of herbs like Picrorrhiza kurroa, Andrographis paniculata, Phyllanthus niruri and Tephrosia purpurea, which offer the best documented hepato-protective effects.