What is a notable effect of prolonged use of metformin?

Prolonged use of metformin is primarily noted for its ability to decrease hepatic glucose production, which is a key mechanism by which it helps manage blood sugar levels in patients with type 2 diabetes. Metformin works by acting on the liver to reduce gluconeogenesis, the process that generates glucose from non-carbohydrate sources. This reduction in glucose production is significant as it leads to lower blood sugar levels and helps improve insulin sensitivity.

Additionally, metformin may have beneficial effects on weight management; most patients experience weight stabilization or slight weight loss rather than weight gain. The drug generally does not induce hypoglycemia when used alone because it does not stimulate insulin secretion, which is often a factor in causing low blood sugar levels. Instead, it focuses on improving the body's glucose handling without the risk of hypoglycemic episodes. Lastly, metformin's mechanism does not increase appetite; rather, it often leads to appetite suppression in some patients.

In summary, the notable effect of prolonged use of metformin on decreasing hepatic glucose production is fundamental to its efficacy in treating type 2 diabetes, distinguishing it from other medications that may have different effects on weight and blood sugar.