This World Diabetes Day (November 14, 2025), Filipino health experts are highlighting a critical yet often overlooked aspect of diabetes management: the role of the liver. Although discussions around type 2 diabetes typically focus on the pancreas, new evidence shows that Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) significantly contribute to insulin resistance.
The Overlooked Link Between Fatty Liver and Diabetes
Global studies reveal that 26% of individuals with type 2 diabetes also have MAFLD/MASLD, a largely silent condition that can progress unnoticed until more severe complications arise. Despite the liver’s central role in blood sugar regulation, fat metabolism, and inflammation control, it is rarely included in routine diabetes assessments.
In the Philippines, the concern is even more urgent. The International Diabetes Federation estimates that 4.7 million Filipino adults are living with diabetes, with many more undiagnosed. At the same time, nearly 20 million Filipinos—1 in 5—are at risk of fatty liver disease, driven by modern lifestyle factors such as increasing obesity rates, sedentary habits, and poor dietary patterns.
Expert Insight: Obesity, Insulin Resistance, and Liver Disease
According to Dr. Jose D. Sollano, Jr., MD, FPCP, FPSG, FSDE, FACP, Professor of Medicine and Gastroenterology at the University of Santo Tomas:
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Over 90% of people with type 2 diabetes are overweight or obese
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70–80% of patients with type 2 diabetes have MAFLD/MASLD
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Insulin resistance is the central link between obesity, diabetes, and fatty liver disease
He explains that in obese individuals, excess fat can accumulate in the liver, muscles, and even the pancreas, disrupting insulin function and glucose use. Obesity often precedes both insulin resistance and type 2 diabetes—and together, these conditions increase the risk of developing MAFLD/MASLD. In advanced stages, fatty liver disease can worsen insulin resistance, making diabetes management even more difficult.
Dr. Sollano emphasizes that early action is vital, especially for Filipinos who are overweight, have abnormal blood sugar levels, or show mild elevations in liver enzymes such as SGPT and SGOT.
A Growing Risk That Requires Greater Awareness
People with MAFLD/MASLD are two to five times more likely to develop type 2 diabetes compared to those without fatty liver disease. Both conditions are driven by shared risk factors—poor diet, inactivity, and metabolic dysfunction—yet routine liver screening remains uncommon in the Philippines, even for high-risk groups.
Research also supports the effectiveness of diagnostic criteria for early identification of fatty liver disease, reinforcing the need for increased education and policy reforms that put liver health front and center.
Liver Health as a Cornerstone of Metabolic Wellness
Health advocates in the Philippines are calling for expanded awareness around liver care, encouraging earlier checkups and preventive lifestyle changes. Strengthening liver health can help reduce the risks of hypertension, cardiovascular disease, and other complications tied to metabolic disorders.
Simple, sustainable improvements—healthier eating habits, more physical activity, and weight control—can significantly lower liver fat and improve overall metabolic outcomes. By supporting liver function, individuals may better manage blood pressure, stabilize blood sugar levels, and reduce long-term health risks commonly linked with diabetes.
A More Complete Approach to Long-Term Health
This World Diabetes Day, experts urge Filipinos to adopt a more holistic view of their health. This includes asking about liver screening during routine checkups, understanding the connection between liver function and blood sugar control, and taking early steps to prevent complications.
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