Editing Pyruvate kinase (section)

==== Inhibitory effect of metformin ====
Metformin, or [[Metformin|dimethylbiguanide]], is the primary treatment used for type 2 diabetes. Metformin has been shown to indirectly affect pyruvate kinase through the inhibition of gluconeogenesis. Specifically, the addition of metformin is linked to a marked decrease in glucose flux and increase in lactate/pyruvate flux from various metabolic pathways. Although metformin does not directly affect pyruvate kinase activity, it causes a decrease in the concentration of ATP. Due to the allosteric inhibitory effects of ATP on pyruvate kinase, a decrease in ATP results in diminished inhibition and the subsequent stimulation of pyruvate kinase. Consequently, the increase in pyruvate kinase activity directs metabolic flux through glycolysis rather than gluconeogenesis.<ref name="Argaud_1993">{{cite journal | vauthors = Argaud D, Roth H, Wiernsperger N, Leverve XM | title = Metformin decreases gluconeogenesis by enhancing the pyruvate kinase flux in isolated rat hepatocytes | journal = European Journal of Biochemistry | volume = 213 | issue = 3 | pages = 1341–8 | year = 1993 | pmid = 8504825 | doi = 10.1111/j.1432-1033.1993.tb17886.x | doi-access = free }}</ref>