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Consequently, the impaired migration ability caused CD4 + /CD8 + T cells prolonged retention in synovial fluids, where lactate could promote CD4 + T cells to transform into Th17 subsets producing abundant IL-17, and to reduce the cytolytic capacity in CD8 + T cells, possibly owing to autoantibody and ectopic lymphoid structures [122]

Dusak A, Atasoy N, Demir H, Dogan E, Gursoy T, Sarikaya E

Redox Biology, 4, 180-183

A glucose kinase-independent HK2 activity prevents TNF-induced cell death by phosphorylating RIPK1

No, metformin should generally be continued whilst B12 deficiency is investigated and treated, as it plays an important role in diabetes management