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Add-on Combination Therapy with Glimepiride, with or without Metformin A total of 441 patients with type 2 diabetes participated in a 24-week, randomized, double-blind, placebo-controlled study designed to assess the efficacy of JANUVIA in combination with glimepiride, with or without metformin

Recent research supports what clinicians are seeing

The article is explicit that dose adjustments should happen only under provider supervision

Bacterial species, especially the phyla Bacteroidetes and Firmicutes, can ferment fibers (the indigestible carbohydrates) to produce branched-chain and short-chain fatty acids (SCFAs), lactate, ethanol, hydrogen, and carbon dioxide