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Improvement of liver function and glycemic control with Combination of DPP-4 inhibitors and GLP-1 agonists in type II diabetes mellitus patients with non-alcoholic steatohepatitis

Gastroenterology & Hepatology: Open Access
Kyaw Hla,1,2Nway Nway,1,2 San Oo Lwin,1,2 Hein Linn Thant,1,3 Chit Pyone Myet Chai,1,2 Nyein Wint Yee Theik,1,2 Mindy Sintsint Lee,1,2 Phone Pyae Win,1,2 Hay Mar Soe,1,2 Yadanar Win Lei,1,2 Alexander Myint Swan1,4,5


Non-alcoholic steatohepatitis (NASH), the aggressive form of non-alcoholic fatty liver disease (NAFLD), can lead to cirrhosis and hepatocellular carcinoma if left without appropriate management. It has been contributing to increasingly devastating mortality and morbidity in a substantial proportion of the human population. Studies on novel therapeutic agents targeting various molecular structures will open up new horizons for doctors dealing with NASH. Of these agents, the combined use of glucagon-like peptide 1 receptor agonist (GLP-1 receptor agonist) and dipeptidyl peptidase-4 inhibitor (DDP-4 inhibitor) showed promising clinical benefits in diabetic patients with NASH in our study. Our study involves a case of a 23-year-old female who presented with a new-onset type 2 DM, poor glycemic control, and NASH.  We found improvement in liver function while getting optimal glycemic control without adverse clinical outcomes. We suggest that DDP-4 inhibitors and GLP-1 receptor agonists could be used together in diabetic patients with NASH while bringing this finding to your attention to have further studies for the advancement in medicine.


non-alcoholic steatohepatitis, type II diabetes mellitus, DDP-4 inhibitor, GLP-1 receptor agonist, glycemic control, diabetes complication, fatty liver, ALT, alanine aminotransferase, AST, aspartate aminotransferase, DKA, diabetic ketoacidosis, NASH, non-alcoholic steatohepatitis, DDP-4 inhibitor, dipeptidyl peptidase-4 inhibitor, GLP-1 receptor agonist, glucagon-like peptide-1 receptor agonist, DM, diabetes mellitus, NAFLD, non-alcoholic fatty liver disease, NAFL, non-alcoholic fatty liver, HbA1c, hemoglobin A1C