Effects of anti-diabetic treatments in type 2 diabetes and fatty liver disease

Elizabeth M. Lamos, Megan Kristan, Maka Siamashvili, Stephen N. Davis

Research output: Contribution to journalArticlepeer-review


Introduction: Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are significant non-communicable diseases that often affect individuals concurrently. In individuals with both T2DM and NAFLD, there is evidence that anti-diabetic therapies may demonstrate potential combined beneficial metabolic and reduced hepatic inflammatory effects. Areas covered: A PubMed and Google Scholar search was performed to find relevant literature. Included studies focused on individuals with T2DM and NAFLD receiving anti-diabetic treatments including bariatric surgery, insulin sensitizers, incretin mimetics, and SGLT2 inhibitors. Additional articles highlight investigational treatments. Expert opinion: In individuals with T2DM and NAFLD, 5–10% weight loss or bariatric surgery if unable to lose weight or maintain weight loss are appropriate. GLP-1 receptor agonists and SGLT2 inhibitors result in weight loss, appear safe and may provide beneficial hepatic outcomes. Whether their effects are related to favorable weight changes or intrinsic hepatic effects is unclear. Thiazolidinediones have advantageous anti-hyperglycemic and hepatic effects but individuals must be monitored for weight gain and edema. Metformin and DPP-4 inhibitor beneficial hepatic effects remain debated. There are opportunities to standardize markers and imaging of NAFLD. Studies powered to evaluate the possible cardiovascular benefits of anti-diabetic therapies in individuals with T2DM and NAFLD are needed.

Original languageEnglish (US)
Pages (from-to)837-852
Number of pages16
JournalExpert Review of Clinical Pharmacology
Issue number7
StatePublished - Jul 2021
Externally publishedYes

Bibliographical note

Funding Information:
This paper was not funded.

Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.


  • Bariatric surgery
  • Sodium-glucose cotransporter-2 inhibitors
  • Thiazolidinediones
  • diabetes mellitus
  • dipeptidyl-peptidase −4 inhibitors
  • metformin
  • nonalcoholic fatty liver disease
  • weight loss

PubMed: MeSH publication types

  • Journal Article
  • Review


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