Aclient with a recent diagnosis of type 2 diabetes has begun taking metformin. this drug will the client achieve adequate blood sugar control through which mechanisms? (select all that apply)
a. binding excess glucose to adipose tissue.
b. decreasing glucose production by the liver.
c. improving insulin sensitivity.
d. decreasing glucose absorption in the gi tract.
e. increasing urinary excretion of glucose.

C. Improving insulin sensitivity.

D. Decreasing glucose absorption in the GI tract.

Explanation:

     Metformin (dimethylbiguanide) is an oral antidiabetic agent derived from guanidine. Metformin does not stimulate insulin secretion. In diabetics, metformin reduces hyperglycemia without the risk of causing hypoglycaemic accidents except in the event of fasting or in combination with insulin or other medicines.

      Metformin reduces hyperglycemia by:

   Peripheral action of metformin on insulin resistance is associated with possible post-receptor action, regardless of  insulin binding with insulin receptors. In addition to its antidiabetic action, metformin has a protective effect on angiopathy risk factors in humans, either directly or through its action on insulin resistance.

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