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it acts together with endothelial nitric oxide synthase (eNOS) and an increase in the availability of nitric oxide (NO), which dilates vessels and improves microcirculation

The efficacy of metformin is in part mediated by the gutpotentially by direct effects on glucose uptake and metabolism, by directly or indirectly increasing GLP-1, by an increase in bile acid exposure and by altering the microbiome

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