What is the mechanism of action for Biguanides (Metformin)?

Biguanides, particularly Metformin, primarily work by decreasing hepatic glucose production, which is a fundamental aspect of how they manage blood glucose levels in individuals with type 2 diabetes. By reducing the amount of glucose produced by the liver, Metformin helps to lower overall blood sugar levels in the body.

This reduction in hepatic glucose output results in lower glucose levels in circulation, which can improve insulin sensitivity and assist in glucose uptake by tissues over time. Metformin also has a secondary effect of enhancing insulin sensitivity in peripheral tissues, particularly in muscle, but its primary and most significant action is the suppression of glucose production by the liver.

The other mechanisms mentioned, such as stimulating insulin release from the pancreas, blocking glucose absorption in the intestines, and enhancing insulin sensitivity in muscle, are not the main actions of Metformin. While they may contribute to the overall management of diabetes, they do not reflect the primary mechanism of action for biguanides like Metformin.