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[28] [29] Patients should maintain open communication with their healthcare team, report new symptoms promptly, and never discontinue prescribed medications without medical guidance

Specifically, the lowering of HGP by metformin required the activation of duodenal glucagon-like peptide-1 receptor (GLP-1R) - protein kinase A (PKA) signaling and a neuronal-mediated pathway connecting the gut and liver via the brain