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16 Before these newer DM medications were available, the commonly utilized PPG-lowering options were metformin, sulfonylureas, bolus insulin, and mixed insulin

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This therefore could mean our understanding of mitochondrial toxicity and insulin resistance is limited A further conflict is supported by the fact that some antidiabetic drugs such as biguanides and thiazolidinediones are known inhibitors of mitochondrial complex I and II, however, these are conventional insulin sensitizers used in clinical settings to date