How does metformin primarily work to lower blood glucose levels? Select all that apply.

Metformin primarily works to lower blood glucose levels through several mechanisms, and one of its key actions is increasing cellular sensitivity to insulin. By improving insulin sensitivity, metformin helps the body utilize glucose more effectively, leading to lower blood sugar levels. This action is particularly important for individuals with insulin resistance, as it allows for better uptake of glucose by the cells, which helps to prevent glucose from remaining in the bloodstream at elevated levels.

In addition, metformin also decreases liver glucose production, which further contributes to its glucose-lowering effects. By reducing the amount of glucose released by the liver into the bloodstream, metformin helps maintain more stable blood glucose levels throughout the day.

The other mechanisms listed in the options, such as decreasing intestinal absorption of glucose and stimulating insulin secretion, are not the primary ways in which metformin operates. Instead, they relate more closely to other medications used in diabetes treatment. Overall, focusing on enhancing insulin sensitivity and reducing hepatic glucose output helps delineate the primary modes of action of metformin in controlling blood sugar levels.