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It is a non-specific SGLT-1 and SGLT-2i that was not used as an anti-hyperglycemic medication due to gastrointestinal side effects until the chemical structure was modified in this decade

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The assessment of TEAE severity was based on the Amgen standard grading scale as follows: mild (aware of symptom, but easily tolerated), moderate (discomfort enough to cause interference with usual activity) and severe (incapacitating with inability to do work or do usual activity)

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Both have been slapped with label updates because of some cases of potential blocked intestine side effects, which have also been reported with Wegovy

However, differences in study subjects and experimental designs, especially the heterogeneity of the gut microbiota itself, have made it difficult to study the modulatory effects of metformin on the gut microbiota