INS and Glucose intolerance: In addition, we adjusted for variables such as cardiovascular instability, high-dose vasopressor, low cardiac output, poor lactate clearance, glucose intolerance requiring insulin, large aspiration, low or zero-dose vasopressor at 48 h, glucose intolerance requiring insulin at 48 h and enteral nutrition at 48 h, all of which are associated with patient severity and metformin use, and found benefits of metformin in patients with septic shock.