Effect of metformin on glycemic control, insulin secretion, and insulin sensitivity in T2D. Effect of metformin on glycemic control, insulin secretion,

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Effect of metformin on glycemic control, insulin secretion, and insulin sensitivity in T2D. Effect of metformin on glycemic control, insulin secretion, and insulin sensitivity in T2D. A: Metformin does not improve muscle insulin sensitivity (measured with euglycemic insulin clamp) in T2D individuals (n = 20) in the absence of weight loss (72). B: Metformin has no effect on β-cell function in T2D individuals (n = 14) (measured with an oral glucose tolerance test [OGTT] and hyperglycemic clamp) (73). C: The primary effect via which metformin reduces the HbA1c in T2D is related to the suppression of hepatic glucose production (HGP) via inhibition of gluconeogenesis (72). FPG, fasting plasma glucose. D: Effect of metformin on HbA1c. Because metformin does not affect muscle insulin sensitivity or β-cell function, following an initial decline after metformin administration, the HbA1c rises progressively in T2D patients (5,6,74). KPNW, Kaiser Permanente Northwest. Muhammad Abdul-Ghani, and Ralph A. DeFronzo Dia Care 2017;40:1121-1127 ©2017 by American Diabetes Association