metformin + secretagogues

Metformin + secretagogues refers to the combination therapy of metformin, a biguanide antihyperglycemic agent, with insulin secretagogues (such as sulfonylureas or glinides) for the management of type 2 diabetes mellitus. Metformin works primarily by decreasing hepatic glucose production, reducing intestinal absorption of glucose, and improving insulin sensitivity in peripheral tissues. Insulin secretagogues stimulate pancreatic beta cells to increase endogenous insulin secretion. This combination is commonly used when monotherapy does not achieve adequate glycemic control and is recommended in international guidelines for patients with type 2 diabetes regardless of BMI[1][3][5][7]. The main risk associated with this combination is an increased likelihood of hypoglycemia due to the action of secretagogues.