Home Forums Other Specialities Endocrinology Metformin for Prediabetes

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      Anonymous
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      Type II Diabetes is becoming a serious threat to healthy living in the modern world. Many are aware of it and some have regular checks of their blood sugar to make sure they are not diabetic.

      A few years ago the American Diabetes Association (ADA), brought forth the term “prediabetes” to warn people that they should consider making lifestyle changes when their blood sugar level was not considered diabetic but was very close to it. The threshold for prediabetes was also lowered from a fasting glucose level of 110 mg/dl to one of 100 mg/dl.

      In 2008, the American Diabetes Association (ADA) began recommending the drug metformin for prediabetes — specifically, for people under age 60 with a very high risk of developing diabetes, for people who are very obese (BMI of 35 or higher), and for women with a history of gestational diabetes. The ADA also said that health-care professionals could consider metformin for anyone with prediabetes or an HbA1c level between 5.7% and 6.4%.

      However according to a recent study, metformin is still rarely prescribed for prediabetes. The study, published in April 2015 in the journal Annals of Internal Medicine, found that only 3.7% of people with prediabetes were prescribed metformin over a three-year period, based on data from a large national sample of adults ages 19 to 58. According to a Medscape article on the study, 7.8% of people with prediabetes with a BMI of 35 or higher or a history of gestational diabetes were prescribed metformin — still a very low rate for the highest-risk groups, in which evidence for the benefits of metformin is strongest. It appears that most doctors simply aren’t following the ADA’s guidelines or aren’t aware of them, as they relate to prediabetes.

      Many articles now indicate that both metformin and lifestyle changes have been very effective at slowing the progression of prediabetes to Type 2 diabetes. I know many of the doctors in India do advise their patients on weight reduction if they are diabetic or in a prediabetic state. However how many would prescribe metformin if their patient’s fasting blood sugar level is 100 mg/dl?

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