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When metformin is administered to these cells, there is no effective target for the drug, as they have altered their pathway of citrate biosynthesis to bypass the tca cycle entirely.

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By decreasing glucose production in the liver, increasing insulin sensitivity, and improving the uptake of glucose in the gi tract and all over the body, metformin lowers blood sugar, decreases insulin resistance, and may prevent or delay the progression of insulin resistance to diabetes.

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