Aim: To assess the prevalence of liver steatosis and fibrosis evaluated through vibration controlled transient elastography (VCTE) in patients with long lasting autoimmune diabetes and their association with different metabolic outcomes. Methods: This is a retrospective, single center, observational study. We included patients with type 1 diabetes or LADA with an available VCTE exam. Only participants wearing either an intermittently scanned or a real-time continuous glucose monitoring (is-CGM or rt-CGM) and with available data on CGM related parameters in the two weeks preceding the VCTE exam were considered. A median controlled attenuation parameter ≥248dB/m was considered indicative of steatosis, while a median liver stiffness measurement ≥8.0 kPa was considered indicative of significant liver fibrosis. Results: We included a total of 56 patients (mean age: 50.4 years, 56.4% males, mean BMI 25.7 kg/m2). Prevalence of steatosis was 30.9%, while only 1 patient (1.8%) had significant liver fibrosis. We found no difference in HbA1c, time in range70-180 (TIR), time above range, time below range or the coefficient of variation between patients with and without steatosis. Patients with steatosis had a higher body mass index (28.9 vs 24.1, p<0.001), a lower estimated glucose disposal rate (eGDR: 6.1 vs 8.2 mg/kg/min, p=0.001) and used higher doses of basal insulin, even after adjustment for body weight. They also had a significantly higher prevalence of diabetic retinopathy (31.3 vs 8.6%, p=0.039). Conclusion: This is the first study evaluating the association between CGM and VCTE-derived metrics in patients with type 1/autoimmune diabetes. We showed that steatosis was relatively common, while fibrosis prevalence was low. Liver steatosis was associated with features of excess adiposity and insulin resistance, rather than with features of glycemic control.