Fatty Pancreas: A Hidden Burden in T2DM : Diabetes Res Clin Pract | June 2026

Introduction:

Fatty pancreas disease (FPD), also known as intrapancreatic fat deposition, has emerged as an important metabolic condition closely linked to obesity, insulin resistance, and type 2 diabetes mellitus (T2DM). Although ectopic fat accumulation in the liver has been extensively studied, pancreatic steatosis has received comparatively less attention despite growing evidence suggesting a role in β-cell dysfunction and metabolic deterioration.

Problem Statement:

The true prevalence of fatty pancreas in patients with T2DM remains uncertain because individual studies have reported highly variable estimates, influenced by differences in population characteristics, imaging modalities, and diagnostic criteria. A comprehensive assessment is needed to clarify the burden of FPD in diabetes and its potential clinical implications.

Summary:

This meta-analysis evaluated the prevalence of fatty pancreas disease among individuals with T2DM by pooling data from observational studies across diverse populations. The analysis demonstrated that fatty pancreas is highly prevalent in patients with T2DM, affecting approximately one-half of individuals with the disease. This finding highlights pancreatic steatosis as a common but often underrecognized component of the diabetic phenotype. Subgroup analyses suggested variability in prevalence across geographic regions and study settings, although the overall burden remained consistently high. Importantly, the prevalence was not significantly influenced by differences in imaging techniques or study period, indicating that the association between T2DM and pancreatic fat accumulation is robust across methodologies. These results support the concept that ectopic pancreatic fat may represent an important metabolic abnormality accompanying diabetes, potentially contributing to insulin resistance, impaired insulin secretion, and disease progression. The findings also reinforce growing interest in the pancreas as a target organ in metabolic disease, analogous to the liver in metabolic dysfunction–associated steatotic liver disease. From a clinical perspective, the study underscores the need for greater awareness of fatty pancreas in patients with T2DM and highlights the importance of future research to determine its prognostic significance, role in diabetes progression, relationship with pancreatitis and pancreatic cancer, and potential responsiveness to lifestyle and pharmacological interventions.