Cirrhosis (liver scarring) can lead to hypoglycemia (low blood sugar). Treating any underlying conditions, avoiding alcohol, eating nutritious foods, and monitoring blood sugar levels can help.

An estimated 1 in 400 American adults have cirrhosis. And in those ages 45–54, the rate is closer to 1 in 200. Many people with cirrhosis will also experience hypoglycemia (low blood sugar levels).

Cirrhosis is scarring of the liver. It may seem like this would not affect blood sugar levels, but if you have cirrhosis, it’s important to watch for symptoms of hypoglycemia. Taking steps to treat the cause of cirrhosis and promote liver health can help prevent serious health complications from low blood sugar.

Your liver acts as both a storage and a manufacturing site for glucose, depending on your body’s needs.

Damage to the cells and structure of your liver from cirrhosis can have a negative effect on your body’s ability to regulate blood glucose levels because your liver cannot release the amount of glucose it usually would. This can mean that you’re more likely to experience hypoglycemia.

Additionally, cirrhosis often occurs in people with diabetes, and these two conditions can feed off each other.

Hormones, including insulin, determine whether your liver should store or release glucose. Under typical conditions, insulin signals your liver to take up extra glucose from your blood. However, liver cirrhosis has been linked with insulin resistance.

When liver damage makes your liver less responsive to insulin, your pancreas is forced to release more insulin. Over time, pancreatic cells may not be able to produce the necessary amounts of insulin. This can lead to higher blood sugar levels and diabetes. And medications meant to regulate this can sometimes overcorrect blood sugar levels, leading to hypoglycemia.

Symptoms of cirrhosis can include:

  • fatigue
  • weight loss
  • nausea and vomiting
  • pain in the upper right side of your abdomen

As liver damage advances, you may experience:

  • bruising and bleeding
  • edema (swelling)
  • confusion and memory loss
  • severely itchy skin
  • jaundice (yellowing of skin)
  • darkening urine
  • ascites (buildup of fluid in your abdomen)

Symptoms of low blood sugar include:

  • sweating
  • hunger
  • fatigue and dizziness
  • paler-than-usual skin
  • shakiness and trembling lips
  • heart palpitations

If hypoglycemia continues untreated, it may cause:

  • blurred vision
  • difficulty concentrating
  • slurred speech
  • seizures
  • loss of consciousness

Acute liver failure is a rare and life threatening condition in which your liver suddenly begins to lose function. Acute liver failure can lead to multiple organ failure.

Research suggests that severe liver injury can lead to hypoglycemia, particularly in older adults with low body weight.

In these situations, glucose infusions can help treat the hypoglycemia but typically will not improve liver function.

Fatty liver disease is a condition in which fat builds up in your liver. It is the most common chronic liver disorder in the United States. Nonalcoholic fatty liver disease (NAFLD) is a type of fatty liver disease that is not caused by heavy alcohol use.

There are two types of NAFLD: nonalcoholic fatty liver and nonalcoholic steatohepatitis (NASH).

NASH is the form of NAFLD that includes inflammation and liver cell damage. NASH can lead to cirrhosis, which may lead to hypoglycemia.

At least one study has found that NAFLD is associated with an increase in hypoglycemia in people with type 2 diabetes.

There is no specific cure for cirrhosis other than a liver transplant, but doctors do have cures for many of the conditions that cause cirrhosis. It’s important to treat the underlying cause.

Your doctor may prescribe medications to help treat cirrhosis and may stop prescribing any medications that are making the cirrhosis worse.

Doctors will typically advise you not to consume alcohol. They may also recommend consuming a well-balanced, nutritious diet and frequently monitoring your blood sugar.

It’s important to follow any directions your doctor provides for treating low (or high) blood sugar. In severe cases, a liver transplant may be necessary.

Cirrhosis (liver scarring) can lead to hypoglycemia (low blood sugar). Treating cirrhosis can improve liver health and reduce your chances of hypoglycemia. While cirrhosis does not have a cure, medications can cure some underlying conditions that cause it.

If you have cirrhosis, it’s important to talk with your doctor about the best treatment options for you. Your doctor will likely recommend that you avoid drinking alcohol. Additionally, eating a nutritious diet and monitoring your blood sugar levels can help with hypoglycemia resulting from cirrhosis.