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Have done ultra sound, liver profile, cholesterol tests. Can online doctor help?

Hi Doctor My Name Maqsood my Ultra sound report = Liver shows increase parease parenchymal echogenicity suggestive of fatty liver, no focal mass seen. Intrahepatic duct not dilated. No free fluid seen around the liver.
Liver Profile= S.Total bilirubin = 0.5 , S.Direct Bilirubin = 0.1 , S.Indirect Bilirubin = 0.4 , GAMMA GT = 39
SGPT ( ALT ) = 43 , Alkaline Phosphatase = 86.
Serum Cholesterol = 174 , Serum TRIGLYCERIDES = 214 , HDL Cholesterol = 26 , LDL Cholesterol = 43 ,
I am Diabetic for 10 years past 9 years amaril Tab= For Last 2 years Insuline use My weight 84 KG Hight 5.5 "
Please guid me
Asked On : Sat, 6 Apr 2013
Answers:  5 Views:  49
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Internal Medicine Specialist 's  Response
Jan 2013
Thanks for posting your query.
Diabetes is a multi organ disease with involvement of almost all organs of body due to its complications.
Blood sugar both fasting and postprandial must be in controlled range.
Diabetes is due to progressive loss or destruction of beta cells in endocrinal part of pancreas.
Let me know your blood sugar status both fasting and postprandial.
Treatment of lipid disorders are decided by LDL and it is in controlled range.
Although triglycerides is on higher side.
Your liver function test is also in normal range.
You should consult with internal medicine specialist/ endocrinologist and should go for thorough check up.
You should take low fat diet along with increased physical activity.
You should take proper treatment for control of sugar along with fenofibrates.
Take care,
Dr. Mayank Bhargava
Answered: Sun, 7 Apr 2013
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General & Family Physician Dr. Pavan Kumar Gupta's  Response
The most common causes for fatty liver are diabetes,alcoholism,high triglycerides,obesity,high sugar intake etc.
Your history suggests that you are overweight,dibetic and having high triglycerides.
Your triglycerides are high along with low HDL cholesterol.
You must observe strict dietary restrictions along with reduction of weight.
Do regular aerobic exercises for atleast 45 minutes a day,which will not only help in reduction of weight but also increase your HDL levels.
Take some statin in consultation with your doctor.
Your target of triglycerides should be below 150 .
Keep your blood pressure below 120/80 .
Keep your sugar levels in tight control.
It would take around six months for your liver to become normal.
Quit alcohol and smoking,if any
Answered: Sun, 7 Apr 2013
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Internal Medicine Specialist Dr. Omer's  Response
you are diabetic with fatty liver
causes of fatty liver(nash)
1.diabetes progression
2.amryl(fatty liver)
3.insulin (weight gain)
fatty liver is of no problem till your liver function remain normal if they rise u wull develop(Nash)...advanced form of fatty liver
treatment includes mainly weight loss+insulin sensitizer
pio/rosi glitAZONE.
Answered: Sat, 6 Apr 2013
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General & Family Physician Dr. Michelle Gibson James's  Response
HI, thanks for using healthcare magic

Fatty liver means that there are parts of the liver that have in more fat than is expected, if it gets worse it can lead to complications.
Fatty liver can be as a result of alcohol use or it can be called non alcoholic fatty liver.
Non alcoholic fatty liver tends to occur in person who may have excess weight though there are other causes that are not as common.

Your blood tests (the liver function tests) are normal so that is a good sign, it implies that the liver is still working properly.
Fatty liver can progress to inflammation of the liver but if lifestyle changes are started this does not have to happen and some of the present problems in the liver may be reversed.

The lifestyle changes will help with the diabetes and cholesterol as well. The HDL cholesterol, which is the good cholesterol , is a little too low. It is suppose to be greater than 40 for a male and 50 for a female.

In terms of the lifestyle changes your would need to , if possible: (1) increase your level of activity to at least 150 mins a week
(2) decrease your use of sodas and fruit juices, these contain fructose which is thought to play a role in developing fatty liver. Use water instead
(3) increase your use of fruits and vegetables, these should be half of your plate for your main meals and be a part of your snacks
(4) decrease your use of fried foods
(5)decrease your carbohydrate intake, this would also help control your blood sugar. These are found in rice/ flour/ roti/some breakfast cereals/bread and biscuits/pasta. when you decrease it you may need to speak to your doctor because the amount of insulin you need will decrease.

I hope this helps
Answered: Sat, 6 Apr 2013
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3 Doctors agree with this answer

Internal Medicine Specialist Dr. Akhilesh Dubey's  Response
Welcome to HCM,
After going through your history, you are Over weight and Diabetic type II, your investigations show fatty liver which is possibly due to diabetes,Obesity and Lipid abnormality.
Your Triglyceride is high 214 mg /dl and HDL is low which is good Cholesterol,and LDL and Total cholesterol is normal, you have not mentioned taht are you taking Statin therapy.
You should take care of diet diabetic and low fat and low calories diet, 25 K cal/ kg body weight and regular exercise helps.
You should try to lose weight, fatty liver improves with UDCA therapy,please control blood sugar and Lipid profile, and if you are taking statin it should continue.
If alcohol use is there it should be stopped and it may increase fatty liver.
After 3 months of therapy test may be repeated you will certainly improvement.
Please take care
Good Luck
Answered: Sat, 6 Apr 2013
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