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One of the possible reasons for this is that metformin inhibits sodium-glucose cotransporter1 (SGLT1) on small intestinal epithelial cells, decreasing the intra- and extracellular Na + concentration gradient, thereby inhibiting intestinal glucose absorption and increasing glucose utilization (Vallianou et al., 2019), increased lactic acid production ( Despite its widespread availability and affordability (Schernthaner and Schernthaner, 2020), metformin is associated with gastrointestinal side effects in around 20% of patients, including nausea, vomiting, diarrhea, bloating, and occasionally lactic acidosis and vitamin B12 malabsorption
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GLP-1s are made every day as a normal part of eating and digestion
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