THE EFFECT OF DIABETES MELLITUS ON LIVER CONDITION

Abstract

Diabetes mellitus, particularly type 2 diabetes, has a significant negative impact on liver condition, and these two states are characterized by a bidirectional relationship. Persistent hyperglycemia and insulin resistance promote the accumulation of triglycerides in hepatocytes, serving as a major cause of metabolic dysfunction–associated steatotic liver disease (MASLD, formerly NAFLD). This condition is observed in 60–80% of patients with type 2 diabetes. Insulin resistance activates de novo lipogenesis and impairs mitochondrial β-oxidation, leading to increased oxidative stress, inflammation (including TNF-α, IL-6, and others), and hepatocellular necrosis. These processes elevate the risk of progression from simple steatosis to metabolic dysfunction–associated steatohepatitis (MASH), followed by fibrosis, cirrhosis, and hepatocellular carcinoma. Diabetes mellitus increases the risk of liver cancer by 2–4 times. At the same time, liver damage further exacerbates insulin resistance, complicates glycemic control, and increases the risk of cardiovascular complications. This thesis highlights the pathogenetic effects of diabetes mellitus on liver pathology, its clinical significance, and the importance of early screening.