G6PD and hyperinsulinemic hypoglycemia, familial, 4: Ruggiero et al. found that the metformin, an oral antidiabetic agent, induced hemolytic anemia when G6PD was deficient [43], and Nikolaidis et al. found exercise did not affect the levels of oxidative stress in G6PD deficiency patients even though the level of GSH was significantly up-regulated [44].