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Interestingly, therapeutic doses of metformin (150 mg/kg) attenuated hepatic insulin resistance in male rats following acute olanzapine treatment, while greater than therapeutic doses of metformin (400 mg/kg) showed an elevation of lactate, a by-product of gut microbiota metabolism (Remington et al., 2015)

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A systematic review of berberine trials found modest glucose-lowering effects, but the quality of evidence was generally low, and direct measurement of incretin hormones was rarely included