Striking a gut-liver balance for the antidiabetic effects of metformin

Metformin is the most prescribed drug for the treatment of type 2 diabetes mellitus (T2DM), but its mechanism of action has not yet been completely eluci-dated. Classically, the liver has been considered the major site of action of met-formin. However, over the past few years, advances have unveiled the gut as an additional important target of metformin, which contributes to its glucose-lowering effect through new mechanisms of action. A better understanding of the mechanistic details of metformin action in the gut and the liver and its rele-vance in patients remains the challenge of present and future research and may impact drug development for the treatment of T2DM. Here, we offer a critical analysis of the current status of metformin-driven multiorgan glucose-lowering effects.

Automated summary

Metformin, the most prescribed drug for T2DM, has both liver and gut as important targets for its glucose-lowering effect through new mechanisms of action. The understanding of metformin's action in these organs and its relevance in patients remains a challenge for current and future research, potentially impacting T2DM drug development.