A review on enhancing glucose utilization in patients on metformin in lifestyle and muscle activity interventions

Abstract

Metformin remains a potent pharmacological agent in the management of type 2 diabetes mellitus (T2DM), primarily improving insulin sensitivity and reducing hepatic glucose production. However, emerging evidence suggests that the efficacy of metformin may be significantly enhanced when combined with targeted lifestyle interventions, particularly those promoting muscle activity such as structured physical exercise.This review aims to critically examine current literature on the synergistic effects of metformin and exercise in improving glucose utilization and metabolic outcomes in patients with T2DM. The review will explore the underlying biochemical mechanisms, including improved GLUT4 translocation, enhanced mitochondrial function, and modulation of AMPK pathways. It will also evaluate clinical outcomes related to glycemic control, insulin resistance, and overall metabolic health.By utilizing available evidence, this article aims to highlight the importance of an integrated therapeutic approach that combines pharmacologic and non-pharmacologic strategies to optimize diabetes management.