"The change of microbiome by artificial sweetener at the end makes fatty liver disease... fried carbs and artificial sweetener support a very fast development of fatty liver disease. Skipping this immediately increases your health." said Dr. Peter Schwarz in a conversation at the WC CKM 2026. Top 5 Takeaways from the Conversation: 1 Dysglycemic Continuum: Metabolic dysfunction begins 15–20 years before diagnosis; hyperglycemia is a late-stage marker. 2 Fatty Liver Driver: Liver fat is the primary trigger for diabetes, causing systemic insulin resistance and pancreatic inflammation. 3 Fasting for Repair: Fasting activates glucagon and autophagy, effectively removing fat from the liver and pancreas. 4 Microbiome Trap: Artificial sweeteners disrupt gut bacteria, producing metabolites that directly drive liver fat accumulation. 5 Pre-Diabetes Window: The critical period for intervention: 10,000 steps daily and eliminating fried carbs and sweeteners. Dr. Peter Schwarz is the President of the International Diabetes Federation (IDF) and a globally renowned diabetologist. He serves as the Professor of Medicine for the Prevention and Care of Diabetes at the Technical University of Dresden. His work focuses on early lifestyle intervention and the physiological mechanisms of diabetes prevention. Dr. P.C. Manoria is the Executive President of the 4th World Congress on CKM and a leading cardiologist based in Mumbai. He is a prominent advocate for integrating cardiovascular and metabolic care to manage the global rise of chronic disease