Welcome to Health Care Magic Diabetic forum: Metformin stimulates the insulin-induced component of glucose uptake into skeletal muscle and adipocytes in both diabetic individual (by pushing glucose from into skeletal muscles and fat tissue it decreases blood glucose levels). Sulfonylurea binds to cells in Pancreas (called β-cells) and induces release of insulin into blood. Insulin ultimately decreases blood glucose. TDZs (Actos and Avandia) has complex mechanism. They act on nuclear receptors called PPAR gamma. It results in alteration in the expression of genes involved in fat and glucose metabolism. Finally they increases insulin sensitivity, meaning Insulin action is increased on muscles and skeletal muscles Good luck- Dr. Jagdish