Abstract： Objective To investigate the relationship between metabolically associated fatty liver disease(MAFLD)and blood glucose fluctuation in hospitalized type 2 diabetes mellitus(T2DM)patients treated with insulin.Methods A total of 1373 T2DM inpatients treated with insulin were collected.The mean values of the coefficient of variation(CV)of daily blood glucose on days 2～3,4～5,and 6～7 were calculated respectively.According to the median of CV2-3,CV4-5 and CV6-7 groups(27.8%,26.0%,24.8%,respectively),subjects were divided into subgroups:CV2-3<27.8%(n=686),CV2-3≥27.8%(n=687);CV4-5<26.0%(n=687),CV4-5≥26.0%(n=686);CV6-7<24.8%(n=686),CV6-7≥24.8%(n=687).Subjects were divided into T2DM combined with MAFLD group(MAFLD,n=793)and T2DM group(n=580).According to the median CV(26.2%,24.4%,23.4%),MAFLD patients were divided into subgroups:CV2-3<26.2%(n=396),CV2-3≥26.2%(n=397);CV4-5<24.4%(n=397),CV4-5≥24.4%(n=396);CV6-7<23.4%(n=396),CV6-7≥23.4%(n=397).According to the MAFLD fibrosis score(NFS),subjects were divided into NFS<-1.455(non advanced liver fibrosis subgroup,n=115),-1.455≤NFS≤0.676(suspected liver fibrosis subgroup,n=514),NFS>0.676(advanced liver fibrosis subgroup).Logistic regression analysis was used to identify risk factors associated with CV.Results Compared with CV2-3<27.8%subgroup,BMI,FC-P and prevalence of MAFLD in CV2-3≥27.8%subgroup were lower(P<0.01).Compared with CV4-5<26.0%subgroup,BMI,FC-P and prevalence of MAFLD in CV4-5≥26.0%subgroup were lower(P<0.01).Compared with CV6-7<24.8%subgroup,BMI,FC-P and prevalence of MAFLD in CV6-7≥24.8%subgroup were lower(P<0.01).Logistic regression analysis showed that BMI,FC-P and HbA1c were the influencing factors of CV2-3≥27.8%;gender,age,BMI,FC-P and MAFLD were the influencing factors of CV4-5≥26.0%;BMI,FC-P and MAFLD were the influencing factors of CV6-7≥24.8%.Compared with T2DM group,CV2-3,CV4-5 and CV6-7 in MAFLD group were decreased(P<0.01);FC-P was increased(P<0.01).Compared with CV2-3<26.2%subgroup,BMI and FC-P in CV2-3≥26.2%subgroup were lower(P<0.01).Compared with CV4-5<24.4%subgroup,BMI and FC-P in CV4-5≥24.4%subgroup were lower(P<0.01).Compared with CV6-7<23.4%subgroup,BMI and FC-P in CV6-7≥23.4%subgroup were lower(P<0.01).CV2-3 in advanced liver fibrosis subgroup was higher than that in suspect liver fibrosis subgroup(P<0.05).Logistic regression analysis showed that FC-P and HbA1c were the influencing factors of CV2-3≥26.2%;FC-P was the influencing factors of CV4-5≥24.4%;the course of DM and FC-P were the influencing factors of CV6-7≥23.4%.Conclusions BMI and FC-P are the influencing factors of blood glucose fluctuation in T2DM patients treated with insulin.Blood glucose fluctuation in patients without MAFLD is large.FC-P is the influencing factor of blood glucose fluctuation in T2DM patients combined with MAFLD.