What are the ADA guidelines for the use of metformin to treat prediabetes?

Updated: Oct 23, 2019
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

The ADA recommends that, in addition to lifestyle counseling, metformin be considered in selected patients with prediabetes. [2] ADA criteria for preventive metformin therapy are as follows:

  • Obesity

  • Age younger than 60 years

  • Both impaired fasting glucose (IFG) and impaired glucose tolerance (IGT)

  • Other risk factors (eg, HbA1C >6%, hypertension, low HDL cholesterol, elevated triglycerides, or a family history of diabetes in a first-degree relative)

In the DPP, metformin 1700 mg daily was about half as effective as lifestyle intervention in reducing risk among subjects with elevated fasting and postload plasma glucose concentrations. [321] Over an average follow-up period of 2.8 years, the incidence of diabetes was 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo, metformin, and lifestyle groups, respectively.


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