A new study from researchers in Germany has uncovered another possible cause of type 2 diabetes, and it may begin in the liver rather than the pancreas alone.
Scientists have found that people with newly diagnosed type 2 diabetes have unusually high levels of a hormone called glucagon, especially when they also have fatty liver disease.
The research was carried out by the German Diabetes Center and published in the journal Diabetes Care. The findings may help explain why blood sugar problems become worse over time and could eventually lead to new treatment approaches.
Type 2 diabetes affects hundreds of millions of people worldwide. It happens when the body can no longer properly control blood sugar levels. Most treatments focus on insulin because insulin helps cells absorb sugar from the bloodstream.
When the body becomes resistant to insulin, sugar stays in the blood instead of entering the cells. Over time, this damages blood vessels and organs and increases the risk of heart disease, kidney disease, blindness, and nerve damage.
But insulin is not the only hormone involved in blood sugar control.
Another hormone called glucagon also plays an important role. Glucagon is made in the pancreas and tells the liver to release stored sugar into the blood when the body needs energy.
Normally, insulin and glucagon work like a balanced team. After meals, insulin rises and glucagon falls. Between meals, glucagon helps prevent blood sugar from dropping too low.
In people with type 2 diabetes, however, this balance appears to break down.
The researchers studied 100 adults, including 50 people recently diagnosed with type 2 diabetes and 50 people with normal blood sugar control. They measured hormone levels, liver fat, and other metabolic markers.
The results showed that people with type 2 diabetes had much higher glucagon levels after meals. Their glucagon levels were about 75% higher than those seen in healthy participants.
The researchers also found that these higher glucagon levels were strongly linked to fatty liver disease.
Fatty liver disease occurs when too much fat builds up in the liver. It is becoming increasingly common around the world due to rising obesity rates, unhealthy diets, and lack of exercise.
Many people with fatty liver disease have no obvious symptoms. However, the condition can slowly damage the liver and strongly increase the risk of type 2 diabetes and heart disease.
Scientists now believe the liver may become resistant to glucagon in a similar way that the body becomes resistant to insulin.
If the liver stops responding properly to glucagon, the body may release even more of the hormone in an attempt to restore balance. Unfortunately, this may worsen blood sugar problems and place extra stress on the body’s metabolic system.
Professor Michael Roden, one of the senior researchers, explained that the findings show type 2 diabetes is more complicated than previously thought. According to the research team, doctors may need to pay more attention to liver health and glucagon regulation in the future.
The study also supports growing evidence that fatty liver disease and type 2 diabetes are deeply connected conditions.
Lead author Maximilian Huttasch said early treatment of fatty liver disease could help reduce diabetes risk. Detecting liver fat earlier may allow people to make lifestyle changes before severe blood sugar problems develop.
Doctors already know that losing weight, improving diet, and increasing physical activity can reduce liver fat in many people. These same lifestyle changes also help lower diabetes risk.
The findings are especially important because several experimental diabetes drugs now being developed target the glucagon system directly. Researchers hope these treatments may improve blood sugar control while also helping treat fatty liver disease.
However, scientists say more research is still needed before any major treatment changes happen. The current study shows a strong connection between glucagon and fatty liver disease, but researchers still need to understand exactly how the process works inside the liver.
The study also highlights how modern metabolic diseases are connected to each other. Obesity, fatty liver disease, insulin resistance, and type 2 diabetes often develop together and influence one another.
As rates of obesity continue rising worldwide, fatty liver disease is becoming far more common, even in younger adults. Many experts believe it may soon become one of the leading causes of chronic liver disease globally.
The new findings suggest that protecting liver health may be one of the most important ways to prevent diabetes in the future.
Overall, the study provides a fresh perspective on type 2 diabetes and suggests that scientists may need to look beyond insulin alone to fully understand and treat the disease.
If you care about diabetes, please read studies about diabetes and vitamin B12, and the right diet for people with type 2 diabetes.
For more health information, please see recent studies about how to eat smart with diabetes, and turmeric and vitamin D: a duo for blood pressure control in diabetic patients.
Source: German Diabetes Center.
