Considering pharmacological therapies for the risk group of NAFLD patients with concomitant T2DM, it needs to be considered that some glucose-lowering drugs promote adipogenesis and the accumulation of e.g. epicardial fat (e.g. sulfonylureas, insulin/insulin analogues), whereas other antidiabetic drugs (e.g. GLP-1 (glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors) reduce the accumulation of ectopic fat but do not reduce inflammation. This evidence concerns the gene GLP1R and metabolic dysfunction-associated steatotic liver disease.