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Long-term follow-up in the DPPOS showed that adherent metformin users maintained roughly 6.2% weight loss below baseline after 15 years, demonstrating durable but modest results particularly in individuals with insulin resistance and higher BMI
NICE guideline NG28 recommends individualised HbA1c targets: typically 48 mmol/mol (6.5%) for adults with type 2 diabetes managed by diet and drugs that don't cause hypoglycaemia, and 53 mmol/mol (7.0%) for those on medicines that can cause hypoglycaemia (such as sulfonylureas or insulin)
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When you lose weight and a significant portion of that loss is muscle, you are getting lighter in a way that leaves you metabolically weaker
