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Metformin is an antihyperglycemic agent primarily used in the management of type 2 diabetes, and its effectiveness is largely attributed to its mechanism of action, which includes improving insulin sensitivity and decreasing hepatic glucose production.

Improving insulin sensitivity means that metformin helps the body's cells, particularly in muscle and fat tissues, to respond more effectively to insulin. This enhanced response facilitates better uptake and utilization of glucose from the bloodstream, ultimately lowering blood sugar levels.

Additionally, metformin reduces the amount of glucose produced and released by the liver. It inhibits gluconeogenesis, which is the process by which the liver generates glucose, especially during fasting. By acting on both liver and peripheral tissues, metformin plays a key role in achieving better glycemic control without causing an increase in insulin secretion, which is important because excessive insulin can lead to hypoglycemia.

While metformin does not block glucose absorption from the gastrointestinal tract, initiate insulin release from the pancreas, or predominantly increase glucose excretion via the kidneys, its primary actions are centered on enhancing insulin sensitivity and reducing hepatic glucose output, making it a cornerstone of diabetes management.