Diabetes can increase the risk of liver damage

In people with diabetes, liver damage including cirrhosis occurs more frequently than it does in healthy individuals.1 Type 2 diabetes is associated with fatty liver hepatitis (NASH). Hormones and protein changes from diabetes also lead to an increased inflammatory response in the body.1

Diabetes itself may be a risk factor for developing cirrhosis.2 On the other hand, people with cirrhosis can develop insulin resistance (pre-diabetes) and/ or “hepatogenic diabetes” (diabetes from liver failure). Diabetes is also diagnosed in up to 30% of all people with cirrhosis.2

Cirrhosis may lead to diabetes

People with cirrhosis produce more glucose (sugar) in the liver, which the cells cannot process as the liver’s ability to absorb sugar is impaired. As a result, “insulin resistance” (insensitivity to insulin) develops.1

Normally, insulin is produced in the pancreas and causes sugar from the blood to be absorbed into the body’s cells for energy. If a person has insulin resistance, the body’s cells are less sensitive to insulin and require more of it to absorb sugar. As a result, the pancreas produces more and more insulin. This creates a vicious cycle in which an increase in insulin production is eventually no longer adequate. The blood sugar levels starts to rise, resulting in diabetes.1

Optimize your diabetes management

Liver diseases are on the increase – just like diabetes. Diabetes is usually treated with medications. If a person has diabetes and cirrhosis at the same time, however, it works differently. The insulin requirements may be reduced due to the impaired insulin metabolism. However, this can lead to an increased risk of hyperglycemia (high blood sugar). Therefore, blood sugar levels should be monitored closely.3

Find out about healthy eating in liver cirrhosis:


  1. Gastaldelli A, Cusi K. From NASH to diabetes and from diabetes to NASH: Mechanisms and treatment options. JHEP Rep. 2019;1(4):312-328.
  2. Garcia-Compean D, Jaquez-Quintana JO, Gonzalez-Gonzalez JA, Maldonado-Garza H. Liver cirrhosis and diabetes: risk factors, pathophysiology, clinical implications and management. World J Gastroenterol. 2009;15(3):280-288.
  3. García-Compeán D, González-González JA, Lavalle-González FJ, González-Moreno EI, Maldonado-Garza HJ, Villarreal-Pérez JZ. The treatment of diabetes mellitus of patients with chronic liver disease. Ann Hepatol. 2015 Nov-Dec;14(6):780-8.

May 2021. GL-HEP-XIF-2000184