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Combined Exenatide and Dapagliflozin Has No Additive Effects on Reduction of Hepatocellular Lipids Despite Better Glycaemic Control in Patients with Type 2 Diabetes Mellitus Treated with Metformin: EXENDA, a 24-Week, Prospective, Randomized, Placebo-Controlled Pilot Trial

Intra-myocardial toxic metabolites of FAs metabolism and triacylglycerol, such as diacylglycerol, ceramides and acylcarnitines, are responsible for severe insulin resistance by interrupting insulin signal cascade at different levels and multiple steps of glucose metabolism (Belfort et al., 2005