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Gastrointestinal adverse events induced by metformin are associated with dose escalation, immediate-release formulations, alterations in gut microbiota, epigenetic susceptibility, inhibition of organic cation transporters, as well as interactions with serotonin, histamine, and enterohepatic circulation [72]

The critical question is therefore: How do we translate these promising findings into safe, real-world practice, ensuring vigilant monitoring for the very patients who couldn't be included in this research?

doi: 10.1159/000441366 196 NichollsWDevonportTJBlakeM