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Interestingly, GLP-1RAs showed significantly more reduction in cardiovascular endpoints than metformin

Kim A, Krishnan A, Hamilton JP, Woreta TA (2021) The impact of dietary patterns and nutrition in nonalcoholic fatty liver disease

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One analysis that showed benefit in type 2 diabetic patients suggests it may be more helpful in younger patients or with short-term treatment (14) , while another associated berberine with anthropometric improvements that may indirectly affect metabolic disease symptoms (15)

Furthermore, most studies relied on surrogate endpoints, such as albuminuria, without directly assessing renal function decline or definitive clinical events