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The primary efficacy endpoint was the change from baseline in HbA1c after 20 weeks of therapy

Nature (2018) 553:5015

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Regarding avian/fish model limitations, we incorporated human clinical data on biomarkers, microbiome profiling, and liver disease outcomes to enhance translational relevance

Metformin is a first-line FDA-approved medication for type 2 diabetes that reduces hepatic glucose production and improves insulin sensitivity