INS and type 2 diabetes mellitus: In a double-blind, randomized trial of 44 metformin-treated patients with T2DM, neither dapagliflozin nor gliclazide significantly altered gut microbiome composition over 12 weeks, despite exhibiting divergent metabolic effects such as reduced weight and fasting insulin with dapagliflozin and increased insulin with gliclazide [40].