What is the mechanism of action of metformin?

Metformin's primary mechanism of action is to decrease hepatic glucose production and increase insulin sensitivity in peripheral tissues, particularly muscle and adipose tissue. This multifaceted approach helps to improve glycemic control in patients with type 2 diabetes. By decreasing the liver's output of glucose, metformin effectively lowers blood sugar levels. Additionally, by enhancing the sensitivity to insulin, it promotes better uptake and utilization of glucose by cells, which further assists in controlling blood sugar levels.

The benefits of metformin also extend to weight neutrality and a low risk of hypoglycemia, making it a cornerstone treatment in managing type 2 diabetes. While the drug does have some effect on intestinal absorption of glucose, this is not its primary mechanism. Metformin does not stimulate insulin production from the pancreas nor specifically instruct adipose tissue to absorb more glucose, distinguishing it from other antidiabetic medications that may employ these mechanisms.