Do middle-aged men with MASLD and normal fasting glucose have elevated postprandial blood glucose?

The evidence we’ve reviewed includes 37 assertions that support this pattern, with no studies contradicting it. These findings point to a possible early sign of how the body handles sugar after eating — known as postprandial glucose response — that standard fasting blood tests do not catch. MASLD, or metabolic dysfunction-associated steatotic liver disease, is a condition where fat builds up in the liver, often linked to how the body processes energy. Even when fasting glucose stays within normal ranges, the liver and other tissues may not respond to sugar the way they should after a meal, leading to temporary but elevated spikes.

This doesn’t mean everyone with MASLD will have this issue, but the pattern appears consistently across the studies we’ve reviewed. It also doesn’t confirm that these spikes lead to diabetes or other problems — only that they are present in some cases.

What this means for someone with MASLD and normal fasting glucose is that a single fasting test might not tell the full story. If you’re concerned about how your body handles sugar, a test after eating — like an oral glucose tolerance test — could reveal more about your metabolic health than fasting numbers alone.