In addition, metformin increases GAS5 expression in HepG2 cells and the plasma of patients with T2DM (Parvar et al., 2023), and elevated GAS5 decreases mitochondrial tricarboxylic acid flux by disrupting the metabolic enzyme tandem of the tricarboxylic acid cycle (Sang et al., 2021), providing another explanation for the mitochondrial inhibition effects of metformin. This evidence concerns the gene GAS5 and type 2 diabetes mellitus.