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Changes in the performance of these proteins have a direct effect on how the drug is absorbed, distributed, metabolized, and eliminated ( Research has shown that variations in the OCT1 gene play a significant role in the varying effectiveness of metformin treatment for individuals with T2DM ( SLC22A1 gene, responsible for OCT1, decreased the absorption of metformin in the liver without impacting the ability of metformin to lower glucose levels in individuals with T2DM (Zhou et al., 2009

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There are several possibilities: First, if you've reached your maintenance dose but aren't tolerating it well, your provider might reduce your dose

Real-world studies have shown the safety and tolerability of GLP-1RAs in MS [41,62]