Hormonal
Metformin lowers blood glucose in Type 2 Diabetes primarily through gut-based pharmacology (altering bile acid recirculation and gut microbiota to enhance GLP-1 secretion) rather than solely through AMPK activation in the liver and muscle.
Metformin's effectiveness in Type 2 Diabetes relies heavily on its interaction with your gut, not just your liver. It changes your bile acids and gut bacteria, which triggers the release of GLP-1, a hormone that helps control blood sugar. This is why taking it orally is crucial; injecting it bypasses this gut mechanism and is less effective.
We hypothesized that the pharmacology of metformin includes alteration of bile acid recirculation and gut microbiota resulting in enhanced enteroendocrine hormone secretion... Our study suggests that metformin has complex effects due to gut-based pharmacology
Why this rating
Randomized, controlled, crossover design with rigorous biochemical profiling, though small sample size (n=12).
Source
Novel Gut-Based Pharmacology of Metformin in Patients with Type 2 Diabetes Mellitus
Antonella Napolitano et al. · PLoS ONE · 2014
DOI 10.1371/journal.pone.0100778
Related findings · Hormonal
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