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While GLP-1s stay in your system for weeks, injecting high doses (2.4mg of Wegovy or 15mg Mounjaro, for example) may cause serious adverse effects

Translation: Keep ginger chews or tea on hand

At the molecular level, metformin inhibits the mitochondrial respiratory chain in the liver, leading to activation of AMPK, enhancing insulin sensitivity (via effects on fat metabolism) and lowering cAMP, thus reducing the expression of gluconeogenic enzymes

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However, people may present with upper and lower GI symptoms, which can result in delayed diagnosis and treatment, and also represent a more severe phenotype

Diabetologia 2008