Liver Fat as a Dietary Target of the Chinese Medical Nutrition Therapy (CMNT) Diet for Treating Type 2 Diabetes With Nonalcoholic Fatty Liver Disease (Version 3.0)

Inclusion Criteria:

• Patients diagnosed with type 2 diabetes and NAFLD.

• Age between 18 and 75 years.

• Body mass index (BMI) > 18.0 kg/m2

• Weight stable for at least 3 months prior to the study (gain or loss <4kg).

• Stable treatment for at least 3 months with 1-3 oral

• antidiabetic medications (with or without insulin therapy), or not yet receivingantidiabetic medication prior to the beginning of the study.

• Able to give written informed consent.

Exclusion Criteria:

• Participants meeting any of the following criteria will not be allowed toparticipate in the trial:

• Use of any of the following medications or treatments:

• Use of other medications that may affect glucose metabolism within the past 2months, including systemic glucocorticoids (excluding inhaled or topical use),growth hormones, etc.;

• Use of antihypertensive or lipid-lowering medications that have not reached a stabledosage before screening;

• Presence of any of the following medical histories or conditions:

• History or presence of any cardiac disease within the past 6 months;

• Decompensated heart failure (NYHA Class III or IV);

• Unstable angina, myocardial infarction, coronary artery bypass grafting, or coronarystenting;

• Uncontrolled or severe arrhythmias (e.g., long QT syndrome), as assessed by theinvestigator as unsuitable for trial participation;

• History of hemorrhagic or ischemic stroke within the past 6 months, as assessed bythe investigator as unsuitable for trial participation;

• Medical history of cerebral thrombosis, cerebral vascular blockage, encephalicangioma, transient ischemic attack, cerebral hemorrhage, stroke, hydrocephalus, ormalignant brain tumor;

• History of carotid artery stenting;

• Urinary system conditions such as nephrotic syndrome, uremia, polycystic kidneydisease, kidney transplantation, unilateral nephrectomy/congenital solitary kidney,renal atrophy, renal tumor;

• Digestive system conditions such as ascites, liver cirrhosis, liver fluke infection,severe hepatitis, gastric varices;

• Nervous system conditions such as cerebellar atrophy, demyelinating diseases,cerebral palsy, Parkinson's disease, mania, schizophrenia;

• Respiratory system conditions such as pulmonary embolism, cor pulmonale;

• Musculoskeletal system conditions such as arterial rupture, myeloma;

• Immune system conditions such as Behçet's disease, lupus erythematosus;

• Conditions such as chondrosarcoma, liposarcoma, brucellosis, leukemia;

• History of malignant tumor within the past 5 years, or currently under evaluationfor potential malignancy;

• History of unstable or treatment-requiring proliferative retinopathy or macularedema within the past 6 months;

• History of diabetic ketoacidosis or hyperosmolar nonketotic diabetic coma within thepast 6 months;

• Currently suffering from lower extremity arteriosclerotic occlusive disease; Historyof severe infection or severe trauma within the past 1 month;

• History of ≥2 severe hypoglycemic episodes within the past year;

• Currently suffering from clinically significant urinary tract/genital infection, ora history of complicated urinary tract infections, or recurrent urinary tractinfections within the past 6 months;

• Currently suffering from uncontrolled hypertension, defined as systolic bloodpressure ≥160 mmHg and/or diastolic blood pressure ≥100 mmHg at screening/baseline,or systolic blood pressure ≤90 mmHg and/or diastolic blood pressure ≤60 mmHg;

• Currently suffering from uncontrolled thyroid dysfunction;

• History of other severe endocrine diseases, such as multiple endocrine neoplasia;

• History of severe hepatic or renal disease;

• Suspected or confirmed history of alcohol or drug abuse;

• Blood donation or blood loss ≥400 mL within the past 3 months;

• Presence of severe psychiatric disorders or language barriers, unwillingness orinability to fully understand and cooperate;

• Pregnant or breastfeeding women;

• Any other conditions deemed unsuitable for trial participation by the investigator.