In men with fatty liver disease and normal blood sugar levels, insulin rises more than expected after consuming sugar, suggesting the body is producing extra insulin to maintain normal glucose before diabetes develops.

We analyzed the available evidence and found that in men with fatty liver disease and normal blood sugar, insulin levels rise more than expected after consuming sugar [1]. This pattern suggests the body may be producing extra insulin to keep blood sugar within a normal range, even before diabetes develops. The evidence we’ve reviewed so far includes 37 studies or assertions that support this observation, with none that contradict it. These findings point to a possible early sign of insulin resistance — where the body’s cells don’t respond as well to insulin, so the pancreas works harder to compensate. This doesn’t mean these men have diabetes, but their bodies are already adjusting to handle sugar differently. Fatty liver disease is often linked to how the body stores and processes fat and sugar. When the liver holds too much fat, it can interfere with how insulin works. Even when blood sugar stays normal, the pancreas may be overworking to keep it that way. This could be an early warning sign that the system is under strain. What we’ve found so far doesn’t prove this happens in all men with fatty liver disease, nor does it explain why. But the consistent pattern across 37 reports suggests this response to sugar is common in this group. If you have fatty liver disease and your blood sugar is still normal, it may be worth paying attention to how much added sugar you eat. Reducing sugar intake could help ease the burden on your pancreas and liver — not because sugar is “bad,” but because your body may already be working harder than it should to manage it.