We included patients aged 18 years with a diagnosis of diabetes previously recorded in EHR encounters who were newly prescribed add-on non-insulin glucose-lowering agents and were on metformin between 2005 and 2020
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Kaneto H et al (2021): Multifaceted Mechanisms of Action of Metformin Which Have Been Unraveled One after Another in the Long History
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When insulin signaling via PI3K-PDPK1-AKT/PKB is impaired, as described above for the insulin resistant (IR) state, the MAPK signaling pathway in endothelial cells is enhanced
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