Inclusion criteria:
Type 2 diabetes is known ( under treatment)
At least one year has passed since their diabetes
NAFLD grade 2 or 3 has been diagnosed by ultrasound
All patients should undergo non -pharmacological life style modification treatment
Exclusion criteria:
Newly diagnosed subjects
Type 1 diabetes
Receiving only insulin treatment
Drug intolerance disorders
Lack of consent to continue treatment
Diagnosis of type 1 NAFLD
Having a weight loss of more than 5 %
Having Infectious diseases , cancer, allergy and immune - based diseases
Smoking and alcohol consumption
Appetite disorders such as anorexia or overeating
Treatment with amphetamine, cyproheptadine, phenothiazine, appetite suppressants or appetite stimulants
Chronic viral hepatitis (HBV-HCV-HDV), drug-induced liver disease , Wilson's disease , hereditary deficiency of antitrypsin 1, idiopathic hemochromatosis, history of complications from liver diseases including ascites , encephalopathy or variceal bleeding
Uncontrolled cardiovascular or respiratory disease , active malignancy or active and chronic infections
The use of agents such as vitamin E- omega 3 fatty acids or drugs with evidence of their effect on NAFLD (pioglitazon , GLP 1analog , dipeptidyl peptidase inhibitors IV ,ursodeoxycholic acid)
Pregnancy or breastfeeding
Use of corticosteroids
Taking herbal medicines whose effect on fatty liver has been proven
Taking any nutritional supplements in the last 3 months