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Horm Metab Res
DOI: 10.1055/a-2787-1205
Review

Exploring the Therapeutic Potential of Sodium–Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis in Patients with Type 2 Diabetes: A Narrative Review

Authors

  • Sulthan Al Rashid

    1   Pharmacology, Saveetha Institute of Medical and Technical Sciences (Deemed to be University), Chennai, India

  • Arun Suriyan

    2   Medical Gastroenterology, Saveetha Institute of Medical and Technical Sciences (Deemed to be University), Chennai, India

  • Mohamed Bilal Azam

    2   Medical Gastroenterology, Saveetha Institute of Medical and Technical Sciences (Deemed to be University), Chennai, India

  • Rajkapoor Balasubramanian 

    3   Faculty of Pharmacy, Karpagam Academy of Higher Education, Coimbatore, India (Ringgold ID: RIN231537)

  • Naina Mohamed Pakkir Maideen

    4   Clinical Pharmacology, Pharmacy practice, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates (Ringgold ID: RIN472580)

  • Kumarappan Chidambaram

    5   Pharmacology, College of Pharmacy King Khalid University, Abha 62223, Saudi Arabia (Ringgold ID: RIN48144)

  • Palanisamy Amirthalingam

    6   Pharmacy practice, University of Tabuk, Tabuk, Saudi Arabia (Ringgold ID: RIN125900)
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Abstract

Metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis are increasingly concerning health issues, especially in people with type 2 diabetes mellitus, where metabolic problems drive liver disease progression. While lifestyle changes remain essential, new drug strategies—particularly sodium–glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists—have gained growing interest for their potential to protect the liver. This review examines how sodium–glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists might help treat metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis, focusing on their mechanisms of action, study evidence, and results from meta-analyses. A thorough search of the literature found studies on how these drugs affect insulin sensitivity, liver fat, and inflammation. Preclinical models show that they can lower liver fat, reduce oxidative stress, and decrease fibrosis markers. Clinical trials and meta-analyses support their potential to improve liver enzyme levels, decrease liver fat, and slow fibrosis growth. Overall, sodium–glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists appear promising in the management of metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis, especially in type 2 diabetes mellitus patients. Still, more long-term research studies are needed to confirm how well they work, how safe they are, and the best way to use them, either alone or in combination with other treatments. These drugs may represent important advances in the treatment of liver diseases linked to metabolic problems.

Keywords

SGLT-2 inhibitors - GLP-1 receptor agonists - MASLD - MASH - type 2 diabetes mellitus - hepatic steatosis, liver fibrosis


Publication History

Received: 15 July 2025

Accepted after revision: 12 January 2026

Article published online:
05 February 2026

© 2026. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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