Morgan Freeman’s Diabetes

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Morgan Freeman is an American actor, producer, and narrator who has Academy and Screen Actors Guild Awards, a Golden Globe Award, the Kennedy Center Honor in 2008, the AFI Life Achievement Award in 2011, the Cecil B. DeMille Award in 2012, and the Screen Actors Guild Life Achievement Award in 2018. He missed part of his press tour for his upcoming TV series Special Ops: Lioness, in which he stars alongside Zoe Saldana and Nicole Kidman.

The news media were told that the 86-year-old actor “had an infection which was contagious so he was not able to travel.” However, if you look at recent pictures of him, you will see that the actor has his jacket tightly buttoned in the front to try to hide his large stomach. That could be a serious sign that his diabetes is out of control. He was diagnosed as being diabetic more than 12 years ago and has written pamphlets, donated money, and made public service announcements to help people with type II diabetes. He has suffered from widespread musculoskeletal pain since he was involved in a serious car accident in 2008. He broke bones and had surgery for his considerable injuries, but the pain may be from his diabetes, which can cause nerve damage, loss of feeling and pain, particularly in the hands and feet.

The Most Common Risk Factor for Diabetes is Abdominal Obesity
Storing fat in your belly is a stronger risk factor for diabetes than just being overweight, and is arguably the most common cause of Type II diabetes in North America today (BMC Public Health, November 18, 2019). Having a big belly is associated with excess fat in the liver, which can cause insulin resistance that causes high blood sugar levels (J Clin Invest, May 19, 2020). Having excess fat in your liver also puts you at high risk for strokes, heart attacks, liver failure, and some cancers. More than 50 percent of people with excess fat in their liver are already diabetic or pre-diabetic (J of Family Med and Prim Care, Dec 2022;11(12):7640-7643), and 11-20 percent of people with excess fat in their liver are likely to suffer liver failure within 10-15 years (Clin Gastroenterol Hepatol, 2015;13:643-540).

You can often tell if a person’s diabetes is under control just by looking at them. People who genetically store most of their fat in their belly also tend to store large amounts of fat in their liver. The vast majority of people with big bellies and small buttocks are already diabetic, and suffer from high rises in blood sugar after they eat. People who have big bellies but who also have big buttocks are less likely to be diabetic.

Signs of a Fatty Liver
You are at very high risk for a fatty liver if:
• You have a big belly and small buttocks. Men are at increased risk for having a fatty liver and being diabetic if their waist circumference is greater than 38.7 inches, and women if it is greater than 36 inches. Measuring a person’s waist circumference is a simple and efficient way to see if people who are not overweight are still at increased risk for diabetes (Arch Med Sci Civil Dis, July 22, 2019;4:e64-e71).
• You can pinch more than two inches of skin and fat next to your belly button.
• A sonogram demonstrates a fatty liver.
• Your blood sugar one hour after eating a meal is greater than 145 mg/dL. You are probably already diabetic, even if your fasting blood sugar is normal (under 100 mg/dL).

Ten to twenty percent of North American adults have a fatty liver, and two to five percent already have liver damage from the excess fat. All diabetics should be checked for a fatty liver; 73 percent of diabetics and 95 percent of obese diabetics have a fatty liver (Gut, 2016;65:1359-68), and 52 percent of insulin-resistant diabetics will develop a fatty liver within three years (Hematology, 2020;72:1230-41).

Treatment of a Fatty Liver
No drugs are available today to reverse the fat buildup in your liver (Gut, Sept 7, 2022;71(10):2123-2134). Researchers are studying some new diabetes medications to treat fatty liver. Current treatments include:
• Medications to lower high cholesterol, high triglycerides and high blood pressure if you need them
• Control of diabetes with lifestyle changes and taking diabetes medications if you need them
• Losing weight if overweight
• Avoiding alcohol
• Following a plant-based diet with vegetables, fruits, whole grains, beans, nuts and other seeds
• Restricting foods with added sugar, all sugared drinks, mammal meat, processed meats, and fried foods. If you have a large belly, limit all refined carbohydrates such as those found in foods made from flour, including bakery products, pastas, and most dry breakfast cereals
• Keep blood levels of hydroxy vitamin D above 30 ng/mL
• Start and maintain a regular exercise program.

Both exercise and calorie restriction reduce liver fat in overweight and obese adults, but only exercise has a dose-dependent effect in reducing liver fat and reducing belly fat (Br J Spots Med, Jan 20, 2023). A review of 105 studies shows that a regular exercise program lowers fasting blood sugar and HBA1c (which measures the amount of sugar stuck on hemoglobin in red blood cells) in both diabetics and non-diabetics, and that each additional 100 minutes per week of physical activity was associated with a mean average decrease of 2.75 mg/dL of fasting blood sugar (Acta Diabetol, (2017) 54:983). Strength training lowers high blood sugar levels and liver fat, even before weight loss occurs (Journal of Endocrinology, Apr 2019;241(1):59-70). Try to move about or exercise before or after you eat. Contracting muscles remove sugar from your bloodstream without needing insulin; see How Exercise Helps to Prevent Diabetes and Heart Attacks