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More particularly, a strong activation of PKC in the endothelium of diabetic patients is observed in the increased generation of ROS and microvascular OS (Nuez-Musa, 2024), and vasoconstriction potentiates and insulin signaling peripherally impairs (Robson et al., 2018)

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While a number of mechanistic studies have found that metformin lowers fasting blood glucose levels by suppressing hepatic glucose production [1,2,3], a substantial body of in vivo data suggest that much of the glucose-lowering action occurs at the level of the gastrointestinal tract, irrespective of its systemic bioavailability [3, 4]

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