A patient with type 2 diabetes is started on metformin. Which mechanism best explains why metformin is preferred as first-line therapy over sulfonylureas for most patients?

A patient with type 2 diabetes is started on

Multiple choice — select the best answer

AMetformin blocks intestinal absorption of all dietary carbohydrates
BMetformin increases renal glucose excretion by inhibiting SGLT-2 transporters
CMetformin stimulates pancreatic beta cells to release more insulin
DMetformin decreases hepatic glucose production and does not cause hypoglycemia or weight gain

✓ Correct answer: D. Metformin decreases hepatic glucose production and does not cause hypoglycemia or weight gain Metformin (Glucophage) works primarily by suppressing hepatic gluconeogenesis; it does not stimulate insulin secretion, so it carries minimal hypoglycemia risk and is weight-neutral, making it first-line per ADA guidelines.

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A patient with type 2 diabetes is started on metformin. Which mechanism best explains why metformin is preferred as first-line therapy over sulfonylureas for most patients?

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