Study of 9,000 Indians Finds Diabetes May Silently Damage Liver Health

A major Indian study, the DiaFib-Liver Study, has revealed a concerning link between Type 2 Diabetes and serious liver damage, highlighting the liver as a “fourth major complication” of diabetes alongside eye, kidney, and nerve disorders.

The findings are published in The Lancet Regional Health: Southeast Asia.

The research found that nearly one in four adults with diabetes in India has clinically significant Liver Fibrosis, while about one in twenty may already have early Cirrhosis.

This damage is largely linked to Metabolically Dysregulated-Associated Steatotic Liver Disease, a condition caused by fat accumulation in the liver due to insulin resistance and metabolic dysfunction.

Experts explain that in diabetes, excess glucose and fat in the body often get stored in the liver. Over time, this can trigger inflammation, leading to fibrosis, where healthy liver tissue is gradually replaced by scar tissue. Unlike simple fat buildup (steatosis), fibrosis indicates disease progression and carries a higher risk of severe complications, including liver failure and increased mortality.

According to researchers, up to 70% of people with diabetes may have fatty liver, which can silently progress to fibrosis without noticeable symptoms. This makes early detection critical, as liver damage often remains hidden until advanced stages.

Key risk factors include obesity, poor blood sugar control, high triglyceride levels, and metabolic syndrome. Even individuals with normal liver test results may still develop advanced fibrosis, making routine screening essential.

Preventive strategies focus on lifestyle management—maintaining a healthy weight, eating a balanced diet, reducing refined carbohydrates and alcohol intake, and engaging in regular physical activity. Monitoring blood sugar, cholesterol, and blood pressure also plays a crucial role.

Importantly, experts emphasize shifting focus from fat accumulation to fibrosis detection through tools like FibroScan. Early identification and intervention can significantly reduce the risk of long-term liver complications in people with diabetes.

REFERENCE: Kumar A, Panda J, Agrawal P et al.; A multicentre survey of liver fibrosis burden in type 2 diabetes in India: the DiaFib-Liver Study; The Lancet Regional Health - Southeast Asia, 2026; DOI: 10.1016/j.lansea.2026.100753