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The primary reason is that the glucose-lowering action of metformin, when used alone, is at least as effective as that of any other oral glucose-lowering drug, without promoting weight gain and only rarely causing excessively low blood sugar

It acts by inhibiting mitochondrial complex I, which reduces ATP production, which results in compensatory upregulation of glycolysis, secondary lactate production, and oxidative stress [434]

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Retrospective studies also suggested that metformin decreased the risk of TB incidence [119, 120], cavitary TB [118], and mortality associated with diabetes mellitus during TB treatment [121]