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Moreover, A double-blind study of patients with T2DM treated with metformin led to significant changes in the relative abundance of more than 80 bacterial species compared with placebo after 4 months, in which an increase in Escherichia and Akkermansia muciniphila and a decrease in Intestinibacter were also observed, whereas most of the changes with placebo occurred in phylum Firmicutes and phylum Proteobacteria (Wu et al., 2017)

At the most fundamental level, any injected compound carries the risks of injection itself: site reactions, subcutaneous infections, abscess formation, and in the context of non-sterile preparation, septicemia

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