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Metformin is a biguanide, so it does not inform your pancreas to release insulin
If you develop persistent nausea or severe GI symptoms, contact your prescriber immediately

What physical changes should I track during treatment

Food and Drug Administration (2020) Clinical use of bulk drug substances nominated for inclusion on the 503B Bulks List B.L
The ADAs consensus since 2018 explicitly states: Consider a GLP-1 receptor agonist before insulin in most patients who need injectable therapy due to their efficacy, lower hypoglycemia risk, and weight loss advantage ( [10] ) ( [11] )
