The pioglitazone group showed reduced liver function and hepatic fat content, increased insulin sensitivity, and improved histologic steatosis, ballooning necrosis and inflammation but no significant difference in improvement of fibrosis compared with the placebo group.11 Cusi et al conducted a similar RCT to compare 101 pre‐diabetes or T2DM patients, consuming a hypocaloric diet plus pioglitazone or the diet plus placebo. Here, INS is linked to diabetes mellitus.