"SGLT2 inhibitors are the molecule of the decade, if not the century. They alter most of the abnormalities caused by diabetes... In my opinion, they are the ideal diuretic because they produce both glycosuria and natriuresis together." said Dr. Prakash Deedwania 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 triggers diabetes by causing systemic insulin resistance and subclinical pancreatic inflammation. 3 Fasting for Repair: Fasting activates glucagon and autophagy, effectively "clearing" fat from the liver and pancreas. 4 Microbiome Trap: Artificial sweeteners disrupt gut bacteria, producing metabolites that drive liver fat accumulation. 5 Pre-Diabetes Window: Critical opportunity for intervention: 10,000 steps daily and eliminating fried carbs and sweeteners. Dr. Prakash Deedwania is a globally recognized authority in cardiology and a Professor of Medicine at UCSF. He is a pioneer in cardiovascular research, specifically focusing on the intersection of diabetes, heart failure, and preventive cardiology. Dr. P.C. Manoria is the Executive President of the 4th World Congress on CKM and a renowned cardiologist based in Mumbai. He is a leading advocate for the "Cardio-Kidney-Metabolic" approach to chronic disease management.