The risk of hypoglycemia on metformin monotherapy is extremely low. Combination therapy with other oral hypoglycemic agents increases this risk. Metformin therapy, unlike other oral hypoglycemic agents, is not associated with weight gain but a modest weight loss of 2-3 kg. Long-term therapy with metformin is also associated with decreases in serum concentrations of plasma triglycerides (10-20% reduction), total cholesterol (5-10% reduction), and LDL cholesterol, with some studies noting a slight increase in HDL cholesterol.

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