High‑Insulin Foods and Lifestyle Raise Liver Disease Risk in Type 2 Diabetes

People who have type 2 diabetes often face a serious liver problem called metabolic dysfunction‑associated steatotic liver disease, or MASLD. Scientists wondered whether the way people eat and live could increase that risk because both diabetes and MASLD share similar metabolic issues, such as insulin resistance and being overweight. They studied adults with type 2 diabetes and asked them about their diet and daily habits using reliable questionnaires. From the answers they calculated four special scores that show how much a diet or lifestyle might raise insulin levels: two for food (EDIH and EDIR) and two for habits (ELIH and ELIR).The results were striking. Those in the top quarter of the EDIR score had almost eight times higher odds of having MASLD. The ELIH score gave a similar rise, while the ELIR score also showed an increased risk, though less dramatic. The EDIH score did not show a clear link. These findings suggest that choosing foods and habits that keep insulin levels high can worsen liver health in people with type 2 diabetes. Adjusting the diet to lower insulin demand could be an important strategy for preventing or managing liver complications in this vulnerable group.