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This has been proposed as an indirect mechanism of action for some of the effects of metformin, and although the precise biological pathways involved remain unclear, a range of actions have been postulated, including changes to bacterial-derived pro-inflammatory compounds, changes to production of circulating bacterial metabolites with actions on AMPK and indirect effects to stimulate release of GLP-1 by the gut [100]

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One possibility is that the drug may be saving lives by reducing levels of inflammation, which in severe cases of COVID can prove deadly

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