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Metformin + colesevelam is a fixed-dose combination of two oral agents used in the management of type 2 diabetes mellitus, particularly for patients who require both glycemic and lipid control. Metformin is a biguanide antihyperglycemic agent that primarily decreases hepatic glucose production and improves insulin sensitivity. Colesevelam is a bile acid sequestrant that lowers LDL cholesterol by binding bile acids in the intestine, thereby increasing their excretion; it also modestly improves glycemic control through mechanisms not fully understood but possibly involving modulation of glucose absorption or signaling pathways. The combination has been shown to significantly reduce hemoglobin A1C and LDL cholesterol levels compared to monotherapy, with an acceptable safety profile[2][3][5][8].
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