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Symposium 9: Hepatic involvement in diabetes: beyond the liver Diabetes and the liver: beyond glycemia Non-alcoholic fatty liver disease (NAFLD) represents the hepatic response to the insult of an altered systemic metabolism. In South America, a 25% of the “healthy” individuals have NAFLD, mainly simple steatosis (SS), and a 20% of this figure can progress to non alcoholic steatosis hepatitis (NASH), which means there is presence of hepatocyte ballooning and inflammation. It is even more important that a 20% of the patients with NASH can progress to fibrosis, or even to cirrhosis. For years, SS has been considered a “benign” disease; although said paradigm is being tested since monitoring of patients with serial biopsies revealed that up to a 25% of the patients with SS progressed to fibrosis. Why is it important to identify patients with fibrosis? Because fibrosis is directly associated with higher mortality.