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National institute for health and care excellence all recommended metformin as a first-line agent for diabetes treatment among individuals with mild ckd, defined by egfr 45 ml min 1.
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Treatment with glucovance resulted in significantly greater reduction in hba 1c and postprandial plasma glucose ppg compared to glyburide, metformin, or placebo.
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76 however, the clinical significance of this is unknown, and the risk of metformin-associated lactic acidosis is most commonly attributed to decreased hepatic uptake rather than increased intestinal production.
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