Researchers have found that one in four adults with Type 2 diabetes in the study had significant liver scarring, and one in twenty already had probable cirrhosis—a stage where the liver is heavily damaged. Most alarming of all, almost none of the patients were aware of the issue.
The liver is the body’s largest internal organ. When it is repeatedly damaged by excess fat, high blood sugar, or alcohol, it tries to heal itself by laying down scar tissue. Over time, this scar tissue builds up, and it develops into fibrosis.
In the early stages, it causes no symptoms. However, as scarring progresses, the liver gradually loses its ability to function. When the damage becomes extensive, the condition is called , at which point the liver can’t repair itself. This can lead to liver failure, internal bleeding, and liver cancer.
According to the study, diabetes accelerates this process. High blood sugar, as well as insulin resistance, promotes fat accumulation in the liver, triggering chronic inflammation and driving the condition of . Now, it is formally called ‘Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD)’, though most people still know it as fatty liver disease.
“Fatty liver has become an epidemic. One of the important reasons for fatty liver is diabetes,” said Dr Ashish Kumar, Senior Consultant, Gastroenterology, Sir Ganga Ram Hospital, New Delhi, and the study’s lead author.
The study noted that people with Type 2 diabetes not only have a higher chance of developing fatty liver disease but also tend to progress faster to advanced scarring and cirrhosis. This makes liver disease a particularly serious, and often invisible, risk for hundreds of millions of people living with diabetes.
Type 2 diabetes affects over million adults worldwide, and that number is expected to cross 780 million by 2045, with the steepest rise in lower-income countries.
India sits at the centre of this crisis. According to an Indian Council of Medical Research , the country already has 101 million people with diabetes and another 136 million with prediabetes, and the total is expected to cross 150 million by mid-century.
