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Rather than trying to force a peptide through the gastrointestinal barrier using formulation technology, several research groups asked whether a small, non-peptide molecule could be designed to activate the GLP-1 receptor directly

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Preclinical and clinical studies have uncovered several gastrointestinal effects of metformin, including stimulation of the incretin hormone glucagon-like peptide-1 (GLP-1) [8], slowing of gastric emptying [8], suppression of intestinal glucose absorption [9], inhibition of bile acid resorption [10, 11] and modulation of the gut microbiota [12]