A new review of Treating Type 2 Diabetes by authors from Switzerland and France again confirms that metformin increased gradually to tolerance remains the first and bedrock drug, because of it’s lower all-cause morbidity and mortality and total lack of significant adverse effects compared to all hypoglycemic drugs.
And this review does not mention metformin’s even more important prediabetic role, in reversing the ignored iceberg epidemic of overweight, obesity, PCOS polycystic ovary syndrome and common lipidemia, and halving the incidence of new type 2 diabetes.
METFORMIN BLOODLEVEL AND RENAL FUNCTION MONITORING: Since metformin is apparently solely excreted by the kidneys, metformin dose must obviously (like eg aminoglycoside and lithium dosing) be mandatorily based on initial and interval monitoring of serum creatinine and metformin levels, estimated creatinine clearance
BUT metformin (a prescription plant extract) ) is only one of a thousand non-prescription food insulin sensitizers. So using a mix of a few dozen (including the metformin parent herb galega) can do the necessary better.