INS and metabolic dysfunction-associated steatotic liver disease: Demethyleneberberine, as the derivative of berberine, exerts protective effects against nonalcoholic fatty liver disease (one of the leading causes of T2D) by activating the AMPK signalling pathway and its downstream effectors involved in lipid metabolism [18] Epiberberine, a stereoisomer of berberine, has been demonstrated to effectively improve hyperglycemia, oxidative stress, and insulin sensitivity by the NRF2/AMPK signalling pathway in T2D mice [19].