Metformin lowers blood glucose primarily by which mechanism?

• A Stimulating insulin secretion from pancreatic beta cells
• B Inhibiting intestinal absorption of dietary carbohydrates
• C Activating AMP-activated protein kinase (AMPK), reducing hepatic gluconeogenesis ✓
• D Blocking renal glucose reabsorption via SGLT2 inhibition

Explanation

Metformin's primary mechanism is activation of AMPK in the liver, which inhibits gluconeogenesis and reduces hepatic glucose output. It does not stimulate insulin secretion (A), inhibit carbohydrate absorption (B, that is acarbose), or block SGLT2 (D, that is gliflozins). Metformin may also alter gut microbiome and increase GLP-1, but AMPK-mediated hepatic effect is primary.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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