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It helps improve insulin sensitivity and activates AMPK often described as the bodys metabolic switch This encourages your body to use energy more efficiently and burn fat instead of storing it

Modified low density lipoprotein and its constituents augment cytokine-activated vascular cell adhesion molecule-1 gene expression in human vascular endothelial cells

PMID: 18574266 DOI: 10.1378/chest.08-0672 Pedersen AK, FitzGerald GA (1984): Dose-related kinetics of aspirin

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I think its a drug that primary care will have an easier time with than a GLP-1 that is more prone to these side effects

Patients should be counseled to temporarily discontinue metformin during acute illnesses, before procedures requiring iodinated contrast, and when experiencing severe vomiting or diarrhea