When Metformin Remains a First-Line Choice Metformin remains the standard initial medication for type 2 diabetes because it is affordable, well-tolerated, has decades of safety data, and addresses insulin resistancethe root driver of many metabolic disorders
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Ultimately, this FOXO4-DRI-mediated mechanism selectively eliminates senescent endothelial cells, which in turn attenuates vascular inflammation and improves endothelial-dependent vasodilation, conferring a significant protective effect on vascular function
For ongoing obesity management, patients should discuss alternative options with their GP or specialist, which may include other pharmacological agents (such as orlistat), behavioural interventions, or referral for bariatric surgery assessment in appropriate cases
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