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This is why regular visual field testing is so important

One of the possible reasons for this is that metformin inhibits sodium-glucose cotransporter1 (SGLT1) on small intestinal epithelial cells, decreasing the intra- and extracellular Na + concentration gradient, thereby inhibiting intestinal glucose absorption and increasing glucose utilization ( Despite its widespread availability and affordability ( 2 Effects of metformin on the gastrointestinal tract 2.1 Effects on glucose uptake and absorption PET-CT imaging-based studies have found that metformin modulates glucose in the intestine ( 18 F-FDG as a contrast agent, PET-CT technology was used to reflect changes in body metabolism through the uptake of the contrast agent by the lesion, where 18 F-FDG is a glucose analog that indicates the degree of glucose uptake and is generally used clinically to quantify tissue metabolism ( 18 F-FDG to T2DM patients treated with metformin, researchers showed that the amount of glucose entering the gastrointestinal system from the circulation was increased, which contributed to the drugs glucose-lowering effect and improved glycemic control ( Mechanistically, metformin inhibits intestinal glucose absorption (Wilcock and Bailey, 199)

[DOI] [PubMed] [Google Scholar] 43.De Silva A, Salem V, Long CJ, Makwana A, Newbould RD, Rabiner EA, et al

Lancet Diabetes Endocrinol 2021;9:825-36.ArticlePubMed 129

Due to the limited research on microdosing, the body's long-term response to these reduced doses remains unpredictable