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Method In this double-blind, randomised, placebo-controlled study, 16 people with type 2 diabetes well controlled with metformin monotherapy (mean age 69 years, HbA 1c 48.2 mmol/mol, diabetes duration 10.4 years) were studied in a crossover design, on four separate days, each at least 7 days apart

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People who miss one dose monthly effectively reduce their annual dose by 12%, translating to 2-4 percentage points less total weight loss

Evidence Strength Definition: Strong: Consistent human RCTs with low bias + clear microbiota-depression mediation