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PMCID: PMC8859548

Metformin is a strongly basic hydrophilic drug with a pKa of approximately 11 is not metabolized and is excreted principally by the kidney

Baseline fasting glucose, HbA1c, a lipid panel, and inflammatory markers establish the clinical context, and the post says repeating them periodically lets a provider judge metabolic trajectory beyond weight alone

Certainly, an increase in IGF-1 action is associated with greater risk for neoplastic disease, a link further supported by this study and others targeting IGF-1Rs, but IGF-1 has been paradoxically associated with protection against osteoporosis, type 2 diabetes, cerebrovascular and cognitive decline in pre-clinical studies, as well as in some human epidemiologic studies 12