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doi: 10.1056/NEJMoa1804989

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Additionally, Metformin has a positive effect on markers of insulin resistance, such as fasting plasma glucose, fasting insulin levels, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) (114, 116118, 121, 122, 125)

Increasing the dose too quickly can lead to increased side effects, while too low of a dose may reduce effectiveness