Innocent

until proven guilty Throughout the world and for manyyears, metformin has been a main-stay of therapy for patients with type 2 diabetes. This highly effective and usu-ally well-tolerated oral agent is, to date, the only one demonstrated to reduce car-diovascular disease (CVD) complications in newly diagnosed type 2 diabetic pa-tients (1). It’s precise mechanism of action remains enigmatic, although it clearly re-sults in a reduction of endogenous glu-cose production, primarily hepatic gluconeogenesis, most likely involving the stimulation of AMP-activated protein kinase activity (2). A peripheral insulin-sensitizing effect in skeletal muscle ha