INS and Hyperglycemia: As for the proposed protective effect of metformin, it is well known that metformin acts by increasing glucose uptake by skeletal muscle and thus reducing hyperglycemia by improving insulin sensitivity through the stimulation of the adenosine monophosphate-activated protein kinase (AMPK), leading to the suppression of gluconeogenesis, protein, and fatty acid synthesis resulting in partial metabolic normalization of hyperglycemia and insulin resistance [54, 55].