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Diabetes Care 24:489494 Green BD, Irwin N, Duffy NA, Gault VA, OHarte FP, Flatt PR (2006) Inhibition of dipeptidyl peptidase-IV activity by metformin enhances the antidiabetic effects of glucagon-like peptide-1

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GLP-1 in the brain stem is activated due to stress and causes a loss of appetite

It also influences fat storage and mobilization, energy levels, and the body ability to access stored fat for fuel

The relative risks of complications, including progression of CKD to end-stage kidney disease (ESKD), CVD and mortality, are increased with both reduced eGFR and elevated UACR levels [1]