Hormonal
Metformin's primary glucose-lowering mechanism involves altering gut microbiota composition to increase butyrate and propionate production and enhance GLP-1 secretion, rather than solely acting via hepatic pathways.
If you take metformin, its effectiveness is partly driven by how it changes your gut bacteria to boost GLP-1. If you experience stomach issues, ask about delayed-release formulations (MetDR) which target the lower gut specifically, potentially reducing side effects while maintaining efficacy.
the pharmacological action of metformin was observed to include alterations in bile acid recirculation and gut microbiota, resulting in enhanced glucagon-like polypeptide-1 (GLP-1) secretion
Why this rating
Supported by multiple human studies, meta-analyses, and delayed-release trials, though the paper notes large-scale Phase III trials are still needed for the specific delayed-release formulation.
Source
The gut microbiome as a target for prevention and treatment of hyperglycaemia in type 2 diabetes: from current human evidence to future possibilities
Louise Brunkwall et al. · Diabetologia · 2017
DOI 10.1007/s00125-017-4278-3
More from this paper
- Targeted delivery of propionate to the proximal colon improves glucose metabolism and reduces energy intake without requiring high fiber intake or a responsive gut microbiota.Moderate
- Faecal Microbiota Transplantation (FMT) from lean donors shows promise for improving insulin sensitivity in metabolic syndrome, but current human evidence is limited, small, and unreplicated.Limited
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