Tolerance & Responsiveness Improvement for Metformin (TRIM)

Exclusion Criteria

• •1. Chronic kidney disease stage 3b, 4 and 5 (eGFR \< 30)
• •2. Insulin use
• •3. Oral steroids use (inhalers and creams are allowed)
• •4. Antibiotic use within the last month
• •5. Artificial heart valves
• •6. Hospitalization for chronic condition within 6 months prior to the study
• •7. History, manifestations or medications of significant metabolic, hepatic, renal, hematological, pulmonary, cardiovascular, gastrointestinal, urological, neurological, psychiatric/ psychological disorders, or social circumstances which in the opinion of the investigator would be expected to interfere with the study or increase risk to the subject.
• •8. Use of other antidiabetic drugs (except glipizide and metformin).
• •9. Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
• •1. Previous severe allergic reaction to metformin hydrochloride, such as angioedema.
• •2. Previous Metformin intolerance causing significant diarrhea or GI-upset. Would not exclude participants who had history of mild diarrhea with metformin use.
• •3. Previous side effects that the subject feels were related to Metformin and the subject is not interested to re-try metformin.