Objective To compare the effect of insulin or insulin secretagogues in the treatment of type 2 diabetes mellitus(T2DM) patients complicated with non -alcoholic fatty liver disease (NAFLD).Methods The study population consisted of 438 patients who were diagnosed T 2DM with B ultrasound checking screen fatty livers . According to different always used medications ,the patients were divided into insulin group and insulin secretagogous group.With the help of the B Doppler examination , the incidence rate of NAFLD was compared between the two groups .Further research chose respectively 113 patients from each group ,continued to use insulin for treatment ( group A);group B continued to use insulin secretagogous treatment (group B).After six months,when the patients visited to hospital again ,the impact of the two classes of drugs on the liver fat deposition was observed .Results There were 156 T2DM patients with NAFLD in group A(65.0％) and 131 T2DM patients with NAFLD in group B(66.2％).After six months of treatment ,TC,TG and LDL-C in group A and group B improved compared with before treatment [group A:TC decreased from (5.81 ±1.52)mmol/L to (4.14 ±1.82)mmol/L,t=3.575,P<0.05;TG decreased from (2.91 ±1.32) mmol/L to (2.14 ±1.40) mmol/L,t =0.770,P<0.05;LDL-C decreased from (3.67 ± 1.48)mmol/L to (3.11 ±1.21)mmol/L,t=2.120,P<0.05.Group B:TC decreased from (5.90 ±0.92)mmol/L to (4.37 ±1.22)mmol/L,t=4.016,P<0.05;TG decreased from (2.65 ±0.88)mmol/L to (2.21 ±1.02)mmol/L, t=0.554,P<0.05;LDL-C decreased from (3.91 ±1.38) mmol/L to (3.38 ±1.34) mmol/L,t=0.401,P<0.05].Changes of fatty liver with B ultrasound:the improvement rate was 10.7％in group A and 9.8％in group B, the difference between the two groups was not statistically significant (P>0.05).Conclusion In the T2DM popula-tion who used insulin or insulin secretagogues ,the prevalence of NAFLD is high .Exogenous insulin does not aggravate the liver lipid deposition .T2DM who used insulin or insulin secretagogues has different degrees of the improvement in blood sugar,lipid,Homa-IR and fatty liver.