Effect of Insulin Versus Triple Oral Therapy on the Progression of Hepatic Steatosis in Type 2 Diabetes

Ildiko Lingvay, Erin D. Roe, Jonathan Duong, David Leonard, Lidia S. Szczepaniak

Research output: Contribution to journalArticle

7 Scopus citations


Background Hyperinsulinemia has been associated with hepatic fat deposition and ensuing insulin resistance. It is unknown if treatment with exogenous insulin in patients with type 2 diabetes, who are most prone to hepatic fat accumulation, would promote the occurrence or worsening of nonalcoholic fatty liver disease. Methods Patients with treatment-naive type 2 diabetes (N = 16) were treated with insulin and metformin for a 3-month lead-in period, then assigned triple oral therapy (metformin, glyburide, and pioglitazone) or continued treatment with insulin and metformin. Hepatic triglyceride content (HTC) - measured by magnetic resonance spectroscopy, serum lipids, glucose, liver function tests, and inflammatory and thrombotic biomarkers were followed for a median of 31 months. Results The 45% decline in HTC during the lead-in period persisted through the follow-up period with no difference between treatment groups at the end of the study (5.26 ± 4.21% in the triple oral therapy vs 7.47 ± 7.40% for insulin/metformin), whereas glycemic control was comparable. Conclusions Improvements in HTC with initial insulin/metformin therapy persisted through the median 31-month follow-up period regardless of the treatment. More importantly, insulin-based treatment did not appear to promote or worsen nonalcoholic fatty liver disease.

Original languageEnglish (US)
Pages (from-to)1059-1063
Number of pages5
JournalJournal of Investigative Medicine
Issue number7
StatePublished - 2012


  • hepatic steatosis
  • insulin
  • triglyceride
  • type 2 diabetes

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

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