Six in Ten with Type 2 Diabetes Have Fatty Liver: Study Finds

A new study published in the Journal of Internal Medicine reveals that nearly 60% of individuals with type 2 diabetes also have fatty liver disease, although only a small fraction show signs of more advanced liver damage.

Fatty liver disease, or metabolic dysfunction-associated fatty liver disease (MASLD), is closely tied to metabolic syndrome - a cluster of conditions that disrupt normal metabolism and increase the risk of type 2 diabetes, cardiovascular disease, and liver complications.

To obtain representative data, the researchers studied more than 300 individuals with type 2 diabetes who were undergoing routine primary healthcare diabetes checks. Using MRI scans, they found that 59% had MASLD. Liver stiffness was also assessed using ultrasound-based technology, which showed that around 7% of participants had signs of early-stage cirrhosis, less than reported in studies conducted at specialist clinics.

Obesity emerged as a key factor in disease progression. In this subgroup, 13% showed early liver scarring, compared to just 2% among those without obesity.

“It’s of great importance to find the few individuals who are at high risk of serious liver disease, because we can do a lot of good for those patients. But it’s like looking for a needle in a haystack,” said Mattias Ekstedt, senior associate professor at Linköping University and consultant in hepatology. “Hopefully, our data will help to find the high-risk individuals among all patients.”

Fortunately, fatty liver isn’t irreversible. Weight loss has been shown to significantly reduce liver fat. The study will follow participants over five years to better identify who is most at risk and to guide future screening efforts.

Reference: Balkhed W, Bergram M, Iredahl F, Holmberg M, Edin C, Carlhäll C-J, et al. Evaluating the prevalence and severity of metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes mellitus in primary care. J Intern Med. 2025;e20103.