Biguanides primarily work by:

Biguanides primarily work by:

• A. Increase hepatic glucose production
• B. Reduce hepatic glucose production and improve insulin sensitivity
• C. Stimulate pancreatic insulin secretion
• D. Inhibit renal glucose excretion

Answer: (B)

Biguanides mainly act by lowering the liver’s production of glucose and by making body tissues more responsive to insulin. Metformin, the key drug in this class, activates AMPK in liver cells, which suppresses gluconeogenesis, so hepatic glucose output decreases. At the same time, it improves insulin-stimulated glucose uptake in muscle and other tissues, enhancing insulin sensitivity overall. Because it does not stimulate pancreatic insulin secretion, it has a low risk of hypoglycemia when used alone. It also doesn’t inhibit renal glucose reabsorption—that’s the action of SGLT2 inhibitors. So reducing hepatic glucose production and improving insulin sensitivity best describes how biguanides work.

Biguanides mainly act by lowering the liver’s production of glucose and by making body tissues more responsive to insulin. Metformin, the key drug in this class, activates AMPK in liver cells, which suppresses gluconeogenesis, so hepatic glucose output decreases. At the same time, it improves insulin-stimulated glucose uptake in muscle and other tissues, enhancing insulin sensitivity overall. Because it does not stimulate pancreatic insulin secretion, it has a low risk of hypoglycemia when used alone. It also doesn’t inhibit renal glucose reabsorption—that’s the action of SGLT2 inhibitors. So reducing hepatic glucose production and improving insulin sensitivity best describes how biguanides work.