What is the mechanism of action of metformin?

Metformin primarily works by decreasing hepatic glucose production, which is a crucial mechanism in managing type 2 diabetes. It achieves this by inhibiting gluconeogenesis in the liver, leading to reduced blood glucose levels. This decreases the amount of glucose that is released into the bloodstream from the liver, thus helping to lower overall glucose levels without causing significant hypoglycemia.

Additionally, metformin improves insulin sensitivity, but that is a secondary action. The primary and most significant effect of metformin in terms of its mechanism is the reduction in hepatic glucose output. The other actions of metformin, such as enhancing peripheral glucose uptake and utilization, complements this mechanism but does not primarily define its action. By acting on the liver’s production of glucose, metformin plays a pivotal role in glucose management for individuals with insulin resistance and type 2 diabetes.