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Hepatic steatosis is closely related to insulin resistance, diabetes mellitus or metabolic syndrome, and is associated with increased risk of cardiovascular and renal disease.74 Hepatic steatosis has been associated with the prevalence and incidence of renal disease

The tradeoffs are different Metformin Usually inexpensive and available as a generic Often causes diarrhea, nausea, or stomach discomfort at first Extended-release formulations may be easier to tolerate May require vitamin B12 monitoring with long-term use Has much more pregnancy-related clinical experience than newer GLP-1 medicines GLP-1 or GIP/GLP-1 medicines Can substantially reduce appetite and weight in eligible patients Commonly cause nausea, constipation, reflux, or diarrhea May make it difficult to eat enough protein, fiber, and micronutrients Can be expensive or difficult to access consistently Are not recommended during pregnancy and require a preconception plan Often require long-term treatment to maintain the full effect Can they be used together