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This combined effect of metformin on glycerol-3-phosphate dehydrogenase, substrate inhibition, and GLP-1 secretion makes it an essential therapeutic option for controlling hepatic gluconeogenesis and maintaining glucose homeostasis in individuals with insulin resistance or T2DM (He et al., 2009)

Specific concerns include post-cholecystectomy syndrome (a cluster of persistent GI symptoms in 1015% of patients) and potential interactions between GLP-1-induced motility changes and pre-existing bile acid malabsorption

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