Kahl S, Gancheva S, Straßburger K, et al. - In this randomized, double-blind, phase 4, placebo-controlled trial, researchers ascertained if the sodium–glucose cotransporter 2 inhibitor empagliflozin (EMPA) decreases liver fat content (LFC) in recent-onset and metabolically well-controlled type 2 diabetes (T2D). For this investigation, 84 patients with T2D were randomly assigned to 24 weeks of treatment with 25 mg daily EMPA or placebo. According to results, EMPA treatment resulted in a placebo-corrected absolute of −1.8% and relative LFC change of −22% from baseline to end of treatment, corresponding to a 2.3-fold greater reduction. In patients with T2D, EMPA effectively decreases hepatic fat with outstanding glycemic control and short known disease duration. Interestingly, despite unchanged sensitivity to insulin, EMPA also decreases circulating uric acid and increases levels of adiponectin. Therefore, EMPA could contribute to the early treatment of nonalcoholic fatty liver disease in T2D.