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Starting metformin at a low dose (500 mg once or twice daily) and gradually increasing over several weeks allows for more gradual glucose reduction, potentially minimizing the magnitude of osmotic lens changes
Unlike the relatively rapid onset of type 1 diabetes, type 2 diabetes usually develops slowly, unnoticed by the patient until routine blood testing reveals elevated glucose (Fonseca 2013
In addition to SCFAs, small but significant amounts of alcohols, including ethanol, propanol, and 2,3-butanediol, can be formed as end-products of pyruvate fermentation (Table 1
