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Metformin is increasingly being used off-label for the management of prediabetes. It can help lower blood sugar and HbA1c levels, potentially delaying or avoiding the onset of type 2 diabetes. The American Diabetes Association recommends metformin for certain people with prediabetes, despite it not being FDA-approved for this use.
Although the ADA and the Endocrine Society recommend metformin for treatment of prediabetes, apparently most clinicians agree with the views described above because currently only 1–4% of people with prediabetes are given metformin (58,59).
Several randomized controlled trials, including the Diabetes Prevention Program (DPP) study, have shown that metformin can significantly lower incident diabetes risk among overweight...
Since the association between prediabetes and cardiovascular disease is due to the associated nonglycemic risk factors in people with prediabetes, not to the slightly increased glycemia, the only reason to treat with metformin is to delay or prevent the development of diabetes.
Metformin dosages for prediabetes depend on how you respond to the medication. Generally, you would start with a lower dose and slowly raise it if needed. Metformin can reverse prediabetes for some people. But lifestyle changes, like diet and exercise, are more effective at reversing the condition.
The American Diabetes Association says that metformin “should be considered” in some patients with prediabetes, especially those considered obese. In addition, metformin use in people with prediabetes might help reduce the risk of cardiovascular disease (CVD), including heart attack and stroke (1).
Yes: High-Quality Evidence Supports Metformin Use in Persons at High Risk. Prediabetes is not a disease. It is a risk factor for a disease (diabetes mellitus).
Prediabetes is when blood sugar levels are higher than normal, but not high enough to be diagnosed with type 2 diabetes. In this article, we’ll discuss why metformin may be used for prediabetes, how to safely take it, and possible short and long-term effects.
The studies do show that patients with prediabetes who take metformin are less likely to have blood glucose levels in the diabetic range after 3 years. It is possible, however, that this is simply a treatment effect and not a prevention of progression at all.
Practice: The authors stated that metformin could be used on a population basis to reduce rates of conversion from prediabetes to diabetes. They recommend a dose of 850mgs twice daily, except in south Asians for whom a lower dose may be more appropriate.