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The glucagon receptor activation is the key driver of this liver benefit

Nearly 25% of the population in western countries have NAFLD and up to 6.5% fulfill the criteria of NASH ( NAFLD is considered the hepatic manifestation of metabolic syndrome ( No pharmacological therapies are approved for the treatment of NAFLD and lifestyle changes focusing on caloric restriction and weight loss constitute the general treatment recommendations

For patients with mild renal insufficiency: (creatinine clearance [CrCl] 50 mL/min, approximately corresponding to serum creatinine levels of 1 Concomitant Use with an Insulin Secretagogue (e.g., Sulfonylurea) or with Insulin : When JANUVIA is used in combination with an insulin secretagogue (e.g., sulfonylurea) or with insulin, a lower dose of the insulin secretagogue or insulin may be required to reduce the risk of hypoglycemia