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Dipeptidyl peptidase-4 inhibitors inhibit dipeptidyl peptidase-4 and thus reduce glucagon and blood glucose levels. Metformin should be used as a second-line medication if clomifene treatment fails. Oral anti-diabetic drugs , insulins and insulin analogs , and other drugs used in diabetes A Metformin decreases high blood sugar , primarily by suppressing liver glucose production hepatic gluconeogenesis. Siskind, Janni Leung, Anthony W. In healthy individuals, this slight excess is cleared by other mechanisms including uptake by unimpaired kidneys , and no significant elevation in blood levels of lactate occurs. Metformin treatment of people at a prediabetes stage of risk for type 2 diabetes may decrease their chances of developing the disease, although intensive physical exercise and dieting work significantly better for this purpose.

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