Vilar-Gomez E, et al. - Among patients with type 2 diabetes and non-alcoholic steatohepatitis, researchers ascertained if the use of metformin long-term can improve survival and lower liver-related outcomes. Between October 2004 and January 2016 at the Indiana University Medical Center, a total of 191 diabetic patients with biopsy-proven non-alcoholic steatohepatitis and bridging fibrosis or compensated cirrhosis were retrospectively identified, of whom 110 were metformin users and 81 were never-users. Investigators found that 85% of metformin users and 88% of non-users had cirrhosis. During follow-up, 7 metformin users and 21 nonusers developed hepatocellular carcinoma, 7 metformin users and 24 nonusers died, and 13 metformin users and 13 non-users were transplanted. In diabetics with non-alcoholic steatohepatitis and advanced fibrosis, an association was found between long-term metformin use and decreased risk of all-cause mortality/transplant and hepatocellular carcinoma. No cases have been noted of hepatotoxicity or lactic acidosis.