when a person has type 2 diabetes, his pancreas has been overproducing and overreleasing insulin in response to rising blood sugar for years. because of years of excess insulin production, excess insulin keys have been opening excess fat cells. this explains why people with prediabetes often have excess fat on outside (midline roll of fat) and on the inside (elevated cholesterol and triglycerides) as well as have the potential to develop a fatty liver.