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Message: <blockquote data-quote="Nellie" data-source="post: 13929" data-attributes="member: 7196">According to my Gretchen Becker supplemented by a quick google.Firstly theres no complete understanding of how metformin works. First a quick  diabetes lesson. Sorry if I'm going in to detail you know/too much detail :wink: If you want to skip the detail the summary is at the bottom.Muscles  need insulin to work effectively. Insulin acts as a key allowing the glucose to enter the muscles. Many people with type 2 have a fault in that insulin doesn't do this job effectively so glucose builds up in the blood.(insulin resistance) When exercising, muscles need much less insulin in order to access glucose.In people without diabetes a second hormone glucagon 'senses' when the blood glucose is low and signals to the liver to produce/release more insulin. People with type 2 may have much more glucogan than normal making  the liver  produce/release more glucose even though there is plenty in the bloodstream.The liver forms glucose from non carbohydrate sources (amino acids and fats). This is called hepatic gluconeogenesis A person with type 2 diabetes may have three times the normal rate of gluconeogenesis. I)It is thought that metformins  main action is in reducing the hepatic gluconeogenesis . That is the formation of glucose from the liver.2)It may help reduce the absorbtion of glucose in the digestive system.3) It may help the cells take up glucose in order to work (in other words it may help overcome insulin resistance.) 4) It is very good as an apetite supressant so helps people who need to lose weight. Its sometimes prescribed for this for people without diabetes.So to conclude it seems that its main action stops your liver from producing extra glucose. At the same time It may  reduce the amount that is absorbed from your meal and may help your cells to utilise it. Thats why you are finding exercise so effective. The metformin is stopping your liver from   producing extra, uneeded glucose. Because  muscle cells need very much less insulin to to use glucose during exercise, the glucose is being used rather than staying in the blood stream. Another good thing is that  the reduced insulin resistance during exercise may last for some time after the exercise stops. (and it may help weight loss which in turn reduces insulin resistance)Here endeth the lessson for today!</blockquote>

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