I can’t get no respect.”  It’s an often-quoted line from a famous comedian, but it could be something that the liver would say if it could talk. While the brain and heart get plenty of attention, and deservedly so, the liver at times appears to get lost in the shuffle.  But it isn’t the largest organ in the body for nothing, and it can’t (and won’t) be ignored.

This massive structure is a complex organ that serves vital functions, so it should come as no surprise that keeping it in proper working order is of utmost importance.  Playing a significant role in the metabolism of protein, carbohydrates, fats, hormones, and other substances, the liver really has its hands full.  And, as diabetics know too well, maintaining metabolic processes at their best functional level is the key to staying healthy, and staying out of the doctor’s office.

So, like caring for a small child, we have to keep an eye on it, shelter it from harmful outside influences, and watch for signs that tell us when something could be wrong. Just as an infant will cry or get fidgety when experiencing discomfort, the liver quite often gives us hints that all is not well. We just have to be cognizant of these signals and heed the warnings of this amazing organ.

As far as the regulation of metabolic processes is concerned, the liver is the go-to part of the body.  It works hard to maintain the body’s homeostasis or balance, wearing two hats at all times—it “makes and breaks.”  When it isn’t actually producing vital nutrients, it is involved in the breakdown and/or detoxification of unnecessary or harmful substances, and their excretion, thus maintaining that all-important balance.

On the “production side,” it generates protein from amino acids, synthesizes steroid hormones, and forms bile acids as degradation products of cholesterol. These bile acids are in turn responsible for solubilizing lipids (principally fats), which promotes their absorption for use by the body’s other organs. In the regulation of cholesterol levels, the liver both produces cholesterol for distribution to cells and also removes excess cholesterol by a conjugation process, leading to its elimination from the body through the stool.

What is of major concern to people with diabetes, though, is the role played by the liver in the metabolism of carbohydrates. When these substances are digested or metabolized, glucose is produced. The liver immediately makes use of this sugar as a source of energy or fuel, and can also store it for later use. Insulin, formed by the pancreas, is secreted in order to aid in the uptake and proper use of glucose by the cells. Like a finely tuned machine, the liver maintains the correct glucose concentration within narrow limits.  When necessary, it can cause the release of glucose from stored carbohydrate reserves when not enough of this sugar is present for normal functioning.  The feedback mechanism between glucose and insulin levels is thus quite sensitive and has to be constantly regulated, with the liver serving as the monitor.

When you have diabetes, this feedback mechanism or cycle is thrown off balance. The liver, like a good mediator during conflict, tries its best to manage things but in the process can become overworked or “over-processed.” This metabolic condition and its treatment (insulin injection, etc.) have been discussed in countless forums, so the effects of abnormalities in the glucose/insulin cycle in diabetes are fairly well known by doctors and patients alike.

What may not be so well documented is how caring for the liver may help to alleviate or prevent some of the more serious manifestations of diabetes. It probably goes without saying that processed foods or fried foods have to be avoided, or at least kept to the bare minimum.  They make the liver’s work harder, simply because they require extra processing in order to be properly absorbed by the body. It’s as if they have to be detoxified.  And the liver is already involved in the detoxification of substances like alcohol and other toxins.  That said, does the avoidance or limited intake of alcohol have to be mentioned?

As if you haven’t been told before, other “should-do’s” include losing weight, or limiting your caloric intake. Although advice on what to eat/not to eat is not in short supply, and is constantly changing as more nutrition studies are carried out, keeping your carbohydrate intake at a low level seems to be a wise choice. Carbs are known to tax the functioning of the liver, seeing as how carbohydrate metabolism (with the resulting glucose/insulin factor) is already a rather involved and easily disturbed process.

There are foods and liquid substances that are thought to “cleanse” the liver. Things like garlic, grapefruit, green tea, olive oil, and apples. The use of probiotics also seems to make sense because they are “strongly believed” to promote microbial balance in the gut flora (the so-called “good” bacteria). In addition, a link between disordered gut flora and fatty liver has been discovered, so probiotics would apparently restore order to the intestinal environment and prevent fat buildup. Other words of advice include a thorough reading of warnings on drug labels. Be aware of drugs that are known to have an adverse effect on liver function (the warning is usually in bold letters or block caps).

A laboratory test called a “liver panel” is now used to screen for liver damage, and measures things like bilirubin, albumin, and certain enzymes.  It is often ordered by the treating physician when signs or symptoms of poor liver function are seen. These include fatigue, vomiting, loss of appetite, jaundice or yellowing of the eyes, dark urine, and light-colored stool.

Although the liver is known to have the capability of regenerating itself when tissue is damaged, this undoubtedly is a very complicated process, about which much study needs to be performed. Because of the ability to regenerate liver cells, this organ is the obvious candidate for stem cell research at major research institutions. But you don’t want your body to reach the point of liver damage, then hope that it will repair that damage on its own.

The important thing at this point is to educate yourself about the function and biochemical features of this vital organ, watching for signs of malfunction and practicing disease prevention to the extent possible. The liver is good to us if we are good to it.  So show it some respect.  Otherwise, expect the evil that lurks within to surface, causing major health problems that possibly could threaten your life.