Beneficial effects of SGLT2 Inhibitors on Fatty Liver in Type 2 Diabetes Mellitus

Objectives: To evaluate the effects of treatment with SGLT 2 inhibitors on fatty liver disease in patients with type 2 diabetes mellitus. Study design: Quasi-experimental study. Place and duration of study: Department of Medicine, PAF hospital Islamabad from Apr-2024 to Mar-2025. Methods: A total of 100 type 2 diabetic patients diagnosed with non-alcoholic fatty liver disease (Grade 1–3) were enrolled and divided into two equal groups. The study group received SGLT2 inhibitor in addition to their existing antidiabetic treatment while controls continued standard antidiabetic treatment. Baseline demographic, anthropometric data, blood glucose and liver enzyme tests were recorded, while the hepatic steatosis was assessed and graded by ultrasound. The primary outcome was the significance of difference in hepatic steatosis grade, while secondary outcomes included significance of difference in liver enzyme levels, glycemic control, waist circumference, and body weight after six months treatment. Results: The mean age of patients was 53.26 ± 9.03 years, with males comprising 59% and females 41% of the study population. At 6-month follow-up, significantly more patients (18%) in the study group achieved complete resolution of steatosis (Grade 0) compared to 2% in the control group, with a significant difference in steatosis grade distribution (χ² = 9.476, df = 3, p = 0.024). Patients on SGLT2 inhibitors showed significant decreased levels of ALT (p = 0.02), AST (p = 0.02), waist circumference (p = 0.01), body weight (p = 0.02) and HbA1c (p = 0.01) compared to the controls. Conclusion: SGLT2 inhibitors show benefits in terms of improved hepatic steatosis, liver enzymes, glycemic control, and anthropometric measures suggesting their potential role in managing the diabetic patients with fatty liver disease.