Hormonal
Metformin (1,500 mg) acutely increases postprandial GLP-1 secretion in patients with type 2 diabetes, contributing approximately 75% to its glucose-lowering effect via direct AMPK-dependent activation of intestinal L cells.
For patients with type 2 diabetes, taking metformin (typically 1,500 mg) with a meal triggers the release of GLP-1, a gut hormone that helps lower blood sugar. This gut-mediated effect accounts for a large portion (approx. 75%) of metformin's immediate glucose-lowering benefit. This mechanism is direct, dependent on AMPK activation in gut cells, and preserved in obese patients and those with diabetes.
Metformin has a direct and AMPK-dependent effect on GLP-1–secreting L cells and increases postprandial GLP-1 secretion, which seems to contribute to metformin’s glucose-lowering effect and mode of action.
Why this rating
Randomized, double-blinded, placebo-controlled clinical trial with ex vivo validation, though limited by small sample size (n=12) and acute dosing.
Source
Metformin-induced glucagon-like peptide-1 secretion contributes to the actions of metformin in type 2 diabetes
Emilie Bahne et al. · JCI Insight · 2018
DOI 10.1172/jci.insight.93936
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