No, even people who have diabetes and are at a normal body weight can have a fatty liver, although overweight people are more likely to have the disease.
Research has shown that the type of diabetes a person has can affect the health of the liver.
For example, people who have type 1 diabetes with controlled hyperglycemia (high blood glucose levels) are much less likely to have a fatty liver.
But there is a 70 percent correlation between liver disease and type 2 diabetes.
In fact, some studies estimate that around 98 percent of people with any type of diabetes have some form of fatty liver disease.
When fat builds up in the liver, it can cause fatigue and abdominal pain. If left untreated, the next stage can be cirrhosis, liver failure, and cancer.
Too much cholesterol or bilirubin in the blood can lead to the formation of gallstones. The material builds up in the gallbladder, then calcifies to form the stones.
What is bile?
Bile is an alkaline liquid composed mostly of water, bile salts, bile pigments (bilirubin), fats, and cholesterol. It is essential for digestion of fats because it breaks down fats into fatty acids, which can then be absorbed by the digestive tract. Bile gets its color from bilirubin, a waste product from the breakdown of worn-out red blood cells.
What is the major purpose of the gallbladder?
The gallbladder (from the Latin galbinus, meaning “greenish yellow”), a pear-shaped, small sac, is mainly a storage vessel.
It is connected by ducts to both the liver and small intestine.
It stores bile until it is needed in the duodenum.
Its name is derived from its usual color of green from the accumulation of bile.
The gallbladder is a nonessential organ.
It may be removed surgically, in a procedure called a cholecystectomy, if it is diseased or injured.
Once the gallbladder is removed, bile flows from the liver directly to the small intestine, where it continues to aid digestion.
The excess bile is then stored in the bile duct.
This is why individuals who have had their gallbladder removed usually lead normal lives and enjoy a regular diet.
What are the two types of gallstones?
Gallstones are hardened masses (stones) of bile.
Gallstones form when bile contains too much cholesterol, bile salts, or bilirubin.
The two types of gallstones are cholesterol stones and pigment stones.
Cholesterol stones are more common, accounting for nearly 80 percent of all instances of gallstones.
They are usually yellow-green in color and are made primarily of hardened cholesterol.
An insufficient amount of water may also contribute to the development of cholesterol gallstones.
Pigment stones are small, dark stones made of bilirubin.
Is there a connection between gallstones and diabetes?
No one understands why, but in general, people with diabetes have more gallstone problems than the general population. One possible reason may be that people with diabetes, in particular, type 2, are often overweight or obese, both conditions being linked to the formation of gallstones. In addition, triglycerides are linked to type 2 diabetes and are thought to encourage gallstone formation.
How serious are gallstones?
Many individuals who have gallstones are asymptomatic, and treatment is not necessary. However, if the stones block a duct, bile may be prevented from entering the small intestine. Surgery is then often recommended to remove the gallbladder. Women between ages 20 and 60 are twice as likely to develop gallstones as men.
The Handy Diabetes Answer Book
HOW DIABETES AFFECTS THE URINARY SYSTEM
THE URINARY SYSTEM
What are the major parts and functions of the urinary system?
The functions of the urinary system include regulation of body fluids, removal of metabolic waste products, regulation of the volume and chemical makeup of blood plasma, and excretion of toxins from the body.
The major parts of the urinary system are the kidneys, the urinary bladder, two ureters, and the urethra, and in men the prostate.
Each component of the urinary system has a unique function.
Urine is manufactured in the kidneys.
The urinary bladder serves as a temporary storage reservoir for urine.
The ureters transport urine from the kidney to the bladder, while the urethra transports urine from the bladder to the outside of the body (it also carries semen; for more about the urethra and male reproduction, see the chapter “How Diabetes Affects the Reproductive System”).
Why is it important for a person with diabetes to drink enough water each day?
One reason that a person with diabetes, or even without diabetes, needs to drink enough water each day is dehydration.
If a person with diabetes becomes dehydrated, then major problems can occur with blood glucose levels (and vice versa).
The kidneys need water to eliminate the body’s excess glucose and some wastes, so if a person does not drink enough water, the kidneys will look elsewhere in the body for fluid in order to function, which means a person will become drier, usually first in the eyes and mouth.
In addition, the higher the glucose level, the more fluids a person drinks (and why thirst is one of the symptoms of diabetes).
The symptoms of mild dehydration include thirst, headache, dry mouth and eyes, dizziness, fatigue, and dark-colored urine.
Severe dehydration causes all those symptoms plus low blood pressure, sunken eyes, weak pulse and/or rapid heartbeat, confusion, and lethargy.
It is interesting to note, too, that older people with or without diabetes do not get dehydration symptoms as readily as younger people.
Thus, if an older person has diabetes or uncontrolled glucose levels, he or she may not be diagnosed with dehydration as readily.
On average, what percentage of a person’s daily intake of water comes from drinking water?
O nly about 50 percent of a person’s daily water intake comes from drinking. Nearly 40 percent of water intake comes from eating certain foods, as water is a major component of most foods (these numbers are only approximations; the percentages fluctuate for each person and for the food and liquids they consume each day). For example, fruits and vegetables may contain more than 90 percent water.
Does drinking water lower a person’s blood glucose level?
No, this idea is a myth. Drinking an adequate amount of water helps eliminate toxins and supports a person’s kidney function. What lower a person’s blood glucose level are insulin, exercise, and the body’s kidney function.
DIABETES AND THE KIDNEYS
What are the kidneys?
The kidneys are located on each side of the spinal column in the lumbar region, just underneath the ribcage.
The kidney has two layers: the outer layer, called the cortex, which is reddish brown and granular, and the inner zone, the medulla, which is a darker, reddish brown in color.
The medulla is subdivided into six to 18 cone-shaped sections called the pyramids.
The pyramids are inverted so that each base faces the cortex and the tops project toward the center of the kidney.
Separating the pyramids are bands of tissue called renal columns.
A renal lobe consists of a renal pyramid and its surrounding tissue.
What are the major roles of the kidneys?
The kidneys have several important roles in the human body.
The two kidneys most people have (people have been born with one kidney or may have a kidney in the “wrong” place, such as low in the pelvic area) are responsible for filtering the blood.
They help control blood pressure by producing rennin, an enzyme that regulates the volume of fluid in the body.
They are important to maintain healthy levels of minerals, such as potassium, chloride, and sodium.
They also are responsible for regulating concentrations of phosphate, which is necessary in maintaining the body’s pH by making sure the body does not become too acidic.
They also process two major hormones, erythropoietin and vitamin D (yes, bioactive vitamin D is considered a hormone).
These hormones help produce red blood cells and help the body convert vitamin D through the skin by the action of sunlight on the skin, respectively.
Anatomy of the human kidney.
How much blood is filtered daily by the kidneys, and how much is filtered in an average lifespan?
The kidneys filter about 120 to 150 quarts (113 to 142 liters) of blood daily and produce about 4 ounces of filtrate per minute.
Each day, about 1.5 to 2 quarts (1.4 to 1.9 liters) of urine are eliminated by the kidneys and eventually excreted.
The entire blood supply is filtered through the kidneys 60 times per day, with the kidneys receiving 20 to 25 percent of the total heart output, or approximately 2.5 pints (1,200 milliliters) of blood per minute.
This means kidneys in a person living 73 years have filtered almost 1.3 million gallons of blood.
What are kidney stones?
Most people who have had a kidney stone attack (called renal lithiasis) will tell you it is a very painful experience.
The stones are usually small, hard deposits that form inside the kidneys and are made of minerals and acid salts.
They often affect many places along the urinary tract from the kidneys to the bladder, and can be in one or both kidneys.
They seem to form when the urine becomes concentrated and/or when the urine contains more crystal-forming substances, such as calcium or uric acid, than can be diluted by the fluid in the urine.
The stones are most commonly classified as calcium, struvite, uric acid, and cystine stones, all of which form for various reasons.
Are kidney stones connected to diabetes?
For some people, yes, there may be a connection between the development of kidney stones and having diabetes. The common risk factors include diet (especially a high intake of animal protein, sodium, and sugar, along with not drinking enough fluids); some medications (for example, in some people who take calcium supplements); a family history of kidney stones (although no one agrees upon this factor versus the influence of diet and environment); and certain health conditions, including gout, obesity, and diabetes.
Is there a rise in the number of people with kidney stones?
According to a recent study published in the Clinical Journal of the American Society of Nephrology, there appears to be a rise in the number of people with kidney stones.
The researchers analyzed data from more than 150,000 people in South Carolina who experienced kidney stones from 1997 to 2012.
They found that the frequency of kidney stones increased 16 percent over the study period, with the biggest increases in children, women, and African Americans.
They also noted that, as past studies have shown, more men have kidney stones than women, but women in this study outnumbered the men with kidney stones among those under age 25.
According to Harvard Medical School, there seems to be no direct reason for the rise in kidney stones. There are some speculations, including the rise in obesity in recent years (and also connected to type 2 diabetes). Some scientists even mention climate change, citing that warmer temperatures may increase dehydration, one of the factors often mentioned as a contributor to kidney stones.
In the United States, what percentage of people who have diabetes develop chronic kidney disease (CKD)?
Even when it is controlled, diabetes can lead to chronic kidney disease (CKD) and eventual kidney failure. In the United States alone, it is often said that diabetes is the most common cause of kidney failure. And even though most people with diabetes do not develop CKD that is severe enough to lead to kidney failure, it is estimated that of the nearly 25.8 million people in the United States with diabetes, around 180,000 are living with CKD as the result of their diabetes.