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Metformin improves insulin sensitivity, reduces hepatic glucose production, and may have longevity benefits

Amide bonds typically favour the trans configuration due to steric and electronic factors

Gastrointestinal symptoms (nausea, vomiting, diarrhea, constipation, and abdominal discomfort) are the most frequently reported, particularly when starting treatment or increasing the dose

"The majority of the reports described patients mistakenly drawing up more than the prescribed dose from a multiple-dose vial during self-administration," officials at the FDA explain

Eur Heart J 44(39):40434140 Neves JS, Leite AR, Mentz RJ, Holman RR, Zannad F, Butler J et al (2025) Cardiovascular outcomes with exenatide in type 2 diabetes according to ejection fraction: the EXSCEL trial