During his recent visit to China, Mr. Harold Lebovitz, Executive Chairman of the American Diabetes Association (ADA) program, praised the development of China and reminded us with concern that when he came to China more than 20 years ago, the prevalence of diabetes in China was only 0.6%, but now the prevalence in big cities has reached 6%, which is a tenfold increase. The reason for this is that our genetic susceptibility and unhealthy lifestyles are the root causes of the disease. While focusing on diabetes, we often overlook the culprit behind diabetes, non-alcoholic fatty liver, which is both a cause of diabetes and the root cause of its development and complications. Therefore, we must pay attention to fatty liver and deal with it in time to bring our metabolic status back to normal. It is not too late to adjust the lifestyle and metabolic disorders after the onset of fatty liver, which is still in a reversible state. If it develops into diabetes and other complications, there is no way back and it is too late to regret. Fatty liver is divided into alcoholic fatty liver and non-alcoholic fatty liver depending on the cause, but the consequences and harms caused by them are the same. Non-alcoholic fatty liver refers to the excessive deposition of liver triglycerides that occurs in patients without a history of excessive alcohol consumption, which is obviously associated with hypertriglyceridemia and impaired lipid metabolism. Moreover, in some patients, fatty liver can be found clinically regardless of the presence of hypertriglyceridemia and obesity. If left uncontrolled, fatty liver can develop into steatohepatitis and fatty cirrhosis with the development of diabetes and cardiovascular disease. The number of people with NAFLD in China has reached 90 million, and is a precursor to diabetes, of which 50% can develop into diabetes. It is believed that NAFLD is also an important component of the metabolic syndrome and is closely related to insulin resistance. The degree of fatty liver disease directly affects the occurrence and development of systemic disorders of lipid and glucose metabolism, and is an important predictor of type 2 diabetes and diabetic cardiovascular disease. It can be said that the occurrence of fatty liver is a signal of insulin resistance and a through train for the development of diabetes. Nowadays, more and more fatty liver is found clinically, and the trend is younger and more complicated. Fatty liver can be found in young people in their 20s on physical examination, and it is also accompanied by hyperlipidemia, abnormal blood pressure, abnormal glucose tolerance and elevated liver enzymes. When asked about their medical history, they often have an irregular life, are accompanied by computers and the Internet day and night, and have an unscientific diet. Early detection and early control of fatty liver is a very important means of prevention and treatment, and if enough attention is paid, reasonable exercise and lifestyle changes will bring you back to normal. If recent weight gain, dizziness after meals, lack of energy, fatigue when moving, vague abdominal pain, fullness and discomfort are clinical signs of hyperlipidemia and fatty liver, if physical examination reveals elevated liver enzymes, abnormal blood lipids and blood glucose, liver ultrasound and, if necessary, CT or MRI should be performed to accurately determine the severity of fatty liver and liver fat content. At the same time, you should go to an experienced specialist for a comprehensive examination, because at this time, fatty liver may be accompanied by abnormalities in glucose tolerance, but it is difficult to detect them during general checkups. If early attention is paid, 60-80% of patients can be saved from the brink of danger and enjoy a normal life free from diabetes and cardiovascular disease. The treatment of fatty liver is mainly comprehensive, and the most effective way is to reduce weight, adjust lifestyle and change diet structure, such as avoiding high-fat diet and over-eating, exercising appropriately after meals, living and resting regularly, not indulging in games and internet, etc. If there are other metabolic disorders, the corresponding liver enzyme abnormalities, glucose tolerance abnormalities, hyperinsulinemia, hyperlipidemia and obesity with other metabolic disorders can be improved with drug therapy under the guidance of doctors. The application of insulin sensitizers, biguanides, statins and other lipid-lowering drugs can achieve obvious results, which can really control fatty liver, reduce diabetes and correct metabolic disorders.