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Remarkably, Shulman's group reported that metformin exerts an in vitro non-competitive inhibition of the enzyme, with a K i value (~40 M) within the clinical range of drug concentrations, leading to increased hepatic cytosolic NADH/NAD + ratio and impaired gluconeogenesis from redox-dependent substrates, such as lactate and glycerol, in rats (49)

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In the event of an accidental overdose, contact emergency medical services or a healthcare professional for guidance