Diabetes and Fatty Liver Disease with Dr. Juan Pablo Frias

In this episode, Dr. Steve Edelman and Dr. Jeremy Pettus dive into a little-known but critical complication of diabetes—fatty liver disease. They are joined by Dr. Juan Pablo Frias, an endocrinologist and metabolic disease expert, to explore why people with diabetes are at significantly higher risk of developing fatty liver and what can be done to prevent, detect, and treat it before it leads to serious complications. They discuss the direct connection between insulin resistance, obesity, and liver health, the silent progression of fatty liver disease, and why liver health should be a key part of diabetes management. The episode also highlights how diabetes medications like GLP-1 receptor agonists (Ozempic, Mounjaro) and SGLT2 inhibitors may help protect the liver in addition to their benefits for blood sugar, heart, and kidney health.

Key Topics:

• Why fatty liver disease is a major but often overlooked complication of diabetes and why doctors are just starting to take it seriously.
• How insulin resistance drives fat accumulation in the liver and why people with type 2 diabetes are at much higher risk.
• The silent progression of fatty liver disease, why most people don’t have symptoms until it’s too late.
• How fatty liver impacts blood sugar control, and why treating your liver could actually improve your diabetes management.
• Why people with diabetes should ask their doctors about liver screening, and how simple lab tests like FIB-4 can detect early signs of trouble.
• The growing connection between diabetes, heart disease, kidney disease, and fatty liver, and why experts now see them as part of the same metabolic syndrome.
• Can diabetes medications also treat fatty liver? The exciting potential of GLP-1s, SGLT2 inhibitors, and new liver-specific treatments like Rezdiffra.
• What lifestyle changes really make a difference? How weight loss, diet, and exercise can help reverse fatty liver and improve diabetes at the same time.

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