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Funding This work was supported by Beijing Municipal Administration of Hospitals Incubating Program (PX2023026) and 2024 Evidence-Based Medical Quality Management Research Project of the National Institute of Hospital Administration, National Health Commission of the People's Republic of China (YLZLXZ24G091)

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From the National Prescription Registry, we obtained the Defined Daily Doses (DDD) variable, which is based on the assumed average maintenance dose per day for a drug used for its main indication in adults, according to the World Health Organization Collaborating Centre for Drug Statistics Methodology ( Of note, exposure to metformin, the exposure drug, and the control drug was assumed to be continuous between initiation and end-of-treatment

The role of Cymbiotika in promoting health through quality supplements