Daijiworld Media Network - Chandigarh

Chandigarh, Apr 1: A major study has identified a “fourth complication” of Type 2 Diabetes, warning that a large number of patients may be progressing towards severe liver damage without showing any symptoms.

The DiaFib-Liver Study, published in The Lancet, is among the largest real-world surveys conducted in a developing nation. It highlights that the liver is now as vulnerable as the heart, eyes, and kidneys in diabetic patients.

The research screened 9,202 adults across 27 hospitals in India and found that one in four patients had significant liver fibrosis, one in seven had advanced disease, and one in 20 had likely progressed to cirrhosis.

Dr Ashu Rastogi from PGIMER said diabetes has emerged as a leading cause of modern liver disease, overtaking infections such as hepatitis B and C in driving liver transplants.

Experts noted that the condition is driven by hepatic insulin resistance, where fat accumulation disrupts the liver’s response to insulin, leading to chronic inflammation and irreversible scarring.

The study also highlighted a “burnt-out” phenomenon, where liver fat disappears as damage worsens, making detection difficult. Alarmingly, significant liver scarring was also found in lean individuals without visible fat deposits, with age and prolonged high blood sugar identified as key risk factors.

Since liver disease often remains symptomless until advanced stages, researchers have called for urgent changes in screening practices. They recommend tools such as the FIB-4 score and FibroScan imaging for early detection, instead of relying solely on standard ultrasounds.

Despite the risks, experts emphasised that the condition is largely reversible with lifestyle changes. A weight loss of 5 per cent can reverse scarring in many patients, while a 10 per cent reduction may halt disease progression in advanced cases.

With global diabetes cases expected to rise sharply, and India already home to over 10 crore diabetics, the findings underline the need to integrate liver health checks into national diabetes programmes to prevent a growing healthcare burden.