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The most clinically significant interaction involves other glucose-lowering medications, particularly insulin and sulfonylureas (such as gliclazide)

Effects of dietary weight loss and exercise on insulin-like growth factor-I and insulin-like growth factor-binding protein-3 in postmenopausal women: a randomized controlled trial

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Muscle is metabolically active tissue: it is where most of your glucose gets used, so holding onto it supports the blood-sugar benefits many people are on these medications for in the first place

Look at the sheer number of people affected

Shi J, Yang XR, Ballew B, Rotunno M, Calista D, Fargnoli MC et al