Diabetes Complications

Fatty Liver and Exercise

If you read my articles about diabetes here regularly, you might have noticed that I rarely cover four topics in the news:

1. Knowing the causes of diabetes. This doesn’t help us control it.

2. Learning how to avoid diabetes. This comes too late for most of us.

3. Reading about great new drugs or treatments, This might have in a decade or so might help us some day — but not now.

4. Worrying about the possible complications of our diabetes. This would just add more negativity to our lives.

Of the 313 articles that I have written here about diabetes in the past three years, I did write 19 of them about complications. But each of them emphasized how to prevent or control one of these complications. That’s how I stay positive about the elephant in the room.

Today I am writing for the second time about one of these complications, fatty liver, and how to prevent it. I know how serious that liver disease can be. My wife, Catherine, who had type 2 diabetes, died one and one-half years ago of liver failure.

About 20 percent of the general U.S. population has nonalcoholic fatty liver disease. From 50 to 70 percent of people with type 2 diabetes have fatty liver. The difference in those proportions is enough to convince me that having a fatty liver is a complication of diabetes.

A couple of years ago my doctor thought that I might have fatty liver after I got some routine blood tests. Then, ultrasound confirmed it (since then, I have reversed this condition). That’s the way we usually learn that we have this complication.

Initially, we may not have any symptoms either from diabetes or fatty liver. That’s why both conditions are so insidious. No big deal, we may think.

But uncontrolled, fatty liver can lead to nonalcoholic steatohepatitis (NASH), which doctors sometimes call nonalcoholic fatty liver disease (NAFLD). That in turn can lead to cirrhosis of the liver.

Unless you can get a liver transplant, cirrhosis is fatal. Liver transplants may be available for people under 70 and my wife was only 69 when she died. But her doctor told her that her weight make a successful transplant unlikely, so she died.

Cirrhosis a well-known consequence of alcoholism. But more people die of nonalcoholic liver disease than from drinking too much. I know that my wife didn’t drink any alcohol.

Yet it turns out that fatty liver is among the complications of diabetes that submit to many different treatments. In my first article about fatty liver here almost two years ago I reviewed several of them.

Now, it appears that a little exercise can reverse the levels of fat in our liver by up to 40 percent. A moderate amount of exercise is all that it takes, according to a study by physical fitness experts at the Johns Hopkins University School of Medicine.

On Friday the researchers presented their findings at the annual meeting of the American Association of Cardiovascular and Pulmonary Rehabilitation. A Johns Hopkins spokesperson sent me the abstract of the study, “Exercise Training Reduces Hepatic Fat in Type 2 Diabetes: A Randomized, Controlled Trial” in Microsoft Word format. Since I couldn’t find it online anyplace else, I posted it on my site.

The researchers divided 77 men and women with diabetes into two groups and measured the liver fat of 44 of the participants.

Why only 44 of the 77 participants? I called Dr. Stewart at the annual meeting to find out.

“When we started the study, we didn’t plan to study hepatic fat,” he replied. “But after we started, some of my colleagues persuaded me to include it.”

Dr. Stewart says the team’s study is the first to specifically demonstrate the beneficial role that exercise plays in controlling hepatic fat levels in people with diabetes.

The researchers put half of the study participants through a moderate program of sustained aerobic exercise consisting of three weekly 45-minute sessions. The participants could bicycle, run on a treadmill, or take brisk walks. In addition, they lifted stacked weights for about 20 minutes, also three times a week — and not at a heavy-duty pace. They asked the other half of the participants to avoid any formal aerobic fitness or gym classes.

Special magnetic resonance imaging scans showed much lower levels of liver fat in the active group, which remained the same in the non-exercising group. The exercising group had 5.6 percent liver fat after six months. The non-exercising group had 8.5 percent.

Until Dr. Stewart and his team does more studies, we can’t tell how significant this is. He says his team’s next steps will be to analyze the long-term effect of moderate exercise on diabetes.

We already knew that exercise makes you feel and look better. It takes glucose out of your blood to use for energy. It helps prevent heart disease, depression, and even some forms of cancer. If you do enough, it will help you to lose weight.

But sadly, the link between exercise and fatty liver came too late for Catherine. It is timely for everyone else who has type 2 diabetes.

This article is based on an earlier version of my article published by HealthCentral.

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  • Mary at

    Is there anything I can take to reduce
    my NAFLD?


  • Coran at

    David, what is the therapeutic dose? And what is the toxic level of dose?
    I’m currently taking 5mg/day of vanadium albion chelate (Swason brand), is this a safe amount to take?

    • David Mendosa at

      Dear Coran,

      As I wrote earlier to someone else, “The problem with vanadium is that the therapeutic dose is VERY close to the toxic dose. I am too concerned with my health to take a chance on it.”


  • sheesh at

    Buy his book if you want to know. By the way…

    Diabetes CANNOT be cured just by taking pills!

  • Garey at

    What is Dr. Julian Whitaker recommended dosage of vanadium for his cure?

  • David Mendosa at

    Dear Prakash,

    Yes, if your blood glucose level is under control, we do not have to take any diabetes medication. The question is, however, what under control means. To me it means having a normal A1C level. And the best information that I have on that is a level of 6.0 or below.

    While I don’t know of any side effects on the liver and kidneys from diabetes medication, it’s always a possibility. However, an even greater possibility is your continuing to drink some alcohol.

    Best regards,


  • Prakash at

    I am having diabetics since 15 Years & did not bother too much about it. Recently When I found I have fatty liver I started Controlling Food & started Making exercises. Recently When I checked after 2 hours of dinner the sugar Levels without taking medicine was in the acceptable limits.This check I have been doing since few days & sugar seems to be under control after i started taking controlled food & exercises & reduction of alcohol! I have reduced alcohol considerably due to fatty liver. As a thumb Rule do U think There is no need for medication if sugar levels are under control? Can someone take these medicines only when sugar level is high??? OR In ANY CASE immaterial of improvent medicines to be continued ??/Pls advise .Do these medicines can have side effects on Liver & kidneys???I request Yr help in guiding me.

  • Jorge at

    Hello Mr. Mendosa,
    my name is Jorge Pérez and I am student of Lund University (Sweden). I am doing my project to finish my studies working on vanadium compounds and their relation with diabetes. It is well known long time ago the capacity of this kind of compounds for the lowering of blood glucose levels but they have harmful side effects and as the other person told you toxicity is a key factor to take into account. They are being investigated and there have been improvements. Results are coming from the combination of vanadium with some organic ligands and one of these compounds BEOV is about to go into phase 2 of clinical trials.
    If you want to know more about this there are a few people well know in the vanadium chemistry world who have been working in this since some years: Dieter Rehder, Chris Orvig, Debbie C. Crans, Sakurai, McNeill, Thompson,…
    They have a lot of articles in relation with “Vanadium and Diabetes”.
    Best wishes,
    Jorge Pérez

  • David Mendosa at

    Dear Steve,

    The problem with vanadium is that the therapeutic dose is VERY close to the toxic dose. I am too concerned with my health to take a chance on it.

    Best regards,


  • Steve in NH at

    Hi David,
    Today in the mail, I received a booklet entitled “The Seven Deadly Diabetes Lies,” by some character named Julian Whitaker, “MD”. As a rule, I am extremely skeptical of this type of thing, but he specifically mentions the use of Vanadium (taken orally, I assume).

    The good doc promises to “cure” Type 2 diabetes in three weeks with his cure-all program (and all for ONLY a paltry $29.98!).

    As I said, I’m a skeptic, and don’t for a minute believe this fella, but the Vanadium angle interests me. Do you have any information that would indicate (either negatively or positively) any corellation between Vanadium and diabetes?

    Thanks for any enlightenment you can provide.


  • David Mendosa at

    Dear Gloria,

    It’s great that you want to control your diabetes even without your doctor’s help. You are, of course, primarily responsible for controlling it, as I have written several places, including http://www.mendosa.com/advice.htm

    Very specifically, the only diet that will allow you to control your diabetes is one that is very low-carb. I have written about it here in several articles. The book that tells it best is the one by Dr. Richard K. Bernstein, “Dr. Bernstein’s Diabetes Solution.”

    While most of the American medical establishment has not yet appreciated the low-carb diet, the establishment is helping you. A low-carb diet will also help you to lose weight, if you need to. And don’t forget the importance of exercise too!

    Best regards,


  • Gloria at

    I was diagnosed with fatty liver a few years ago. I have type 2 diabetes and my general practitioner hasnt seemed to do more than basic care for it. I am taking 1000 mg metformin per day and am out of control with spikes and dives. Is there a daily diet I can follow? Very specific, exactly what to eat and when per day?