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Persistence with antidiabetic treatment has been shown to play an important role in glycaemic control, being associated not only with better clinical outcomes but also with economic benefits [8, 9]

The randomized controlled trial of PIVENS selected non-diabetic and non-cirrhotic MASH patients, conducted a 2-year trial of vitamin E (800 IU/d), pioglitazone and placebo and showed that vitamin E had significant histological improvements and that 36% of patients treated with vitamin E had improved steatosis, inflammation and remission of MASH (257)

As with any medication, there may be potential side effects and interactions with other drugs, so regular follow-up with a healthcare provider is essential

Many patients describe broader lifestyle wins as their habits steady, including better sleep, more consistent meals, and a clearer sense of routine