Here is Elcelyx's explanation of why this works:
Metformin DR uses an enteric-coating technology to accomplish once-daily, targeted delivery to the region of the gut where the density of L cells is high. Delaying release of metform into the distal intestine reduces bioavailability while still achieving efficacy. Metformin DR once-daily administration in patients with type 2 diabetes resulted in comparable glucose lowering to Metformin XR with a 40% lower dose and substantially lower systemic exposure. This reduction in systemic exposure may allow for metformin use in type 2 diabetes patients with renal impairment, not all of whom can use existing metformin products. Because metformin is not “wasted” to the circulation, lower doses can be used and bypassing the upper GI should lead to improved tolerability, without the need for dose titration upon initiation of therapy.
Improved glycemic control with minimal systemic metformin exposure: Effects of Metformin Delayed-Release (Metformin DR) targeting the lower bowel over 16 weeks in a randomized trial in subjects with type 2 diabetes
The Primary Glucose-Lowering Effect of Metformin Resides in the Gut, Not the Circulation: Results From Short-term Pharmacokinetic and 12-Week Dose-Ranging Studies.
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