Thomas Colletti, DHSc, PA-C
Purpose: The purpose of this article is to review if new diabetic medications are effective to decrease hepatic steatosis or reverse fibrosis in type 2 diabetic (T2DM) patients with non-alcoholic fatty liver disease (NAFLD).
Method: A systematic review was performed for published studies for the effectiveness of new diabetic medications for NAFLD with concomitant T2DM in the last five years. As the basis of this clinical review, this was narrowed down to 10 studies that investigated sodium glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and dipeptidyl peptidase 4 (DPP-4) inhibitors.
Results: Sodium glucose cotransporter 2 inhibitors and GLP-1 receptor agonists might improve hepatic steatosis and liver enzyme abnormalities in diabetic patients. Some may only be effective in reducing hepatic steatosis as an addition to other medications. DPP-4 inhibitors have not shown improvement of NAFLD or serum markers. SGLT2 inhibitors, GLP-1 receptor agonists, and DPP-4 inhibitors did not meet outcomes of hepatic fibrosis reversal.
Conclusion: The diabetic medications investigated for NAFLD treatment have secondary weight loss in obese patients, reduce the progression of chronic kidney disease, and decrease cardiovascular risk, which would be all necessary targets for patients with T2DM. These secondary benefits are not seen with the other agents that target inflammation and fibrosis. Tailoring treatment with new diabetic medications for NAFLD patients with T2DM and minimal fibrosis should be considered.
Shah V. New Diabetic Medications for Non-Alcoholic Fatty Liver Disease Treatment in Type 2 Diabetic Patients. Lynchburg Journal of Medical Science. 2021; 3(2).
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