In a way, the best, and most cost-effective, way to treat diabetes is to prevent it. A new study suggests metformin might help people with prediabetes avoid a Type 2 diabetes diagnosis, but only when the drug treatment is combined with lifestyle intervention.
Researchers in India tracked just under 600 overweight people with prediabetes divided into two groups: those in an intensive lifestyle intervention program that included the option of taking metformin and those given standard care without metformin.
Over the course of four months, patients in the metformin-plus-intervention program attended weekly educational classes on diet and exercise, followed by an additional two months of weekly education meetings; metformin was prescribed as needed. Those in the control group had one-time visits with a physician, a dietician, and a fitness trainer, and attended a group class on diabetes prevention through diet and exercise; this group did not receive metformin. It is not clear from the report on this study how many weeks this class lasted for the control group.
Both groups were tracked for three years, according to a report in Diabetes in Control. Researchers found those in the intervention-plus-metformin group had a 3.3 percent lower risk of developing Type 2 diabetes each year than the control group. However, the intervention-plus-metformin program cut the risk more for those who had both impaired fasting glucose and impaired glucose tolerance; this group had a 36 percent lower risk of developing diabetes compared with the control group.
Metformin works by decreasing glucose production by the liver and increasing the insulin sensitivity of body tissues. Metformin has been in use since 1957 and is currently on the World Health Organization’s List of Essential Medicines.
Unfortunately, this study seems to provide only an apples to oranges comparison of metformin’s effectiveness, as researchers declined to give the control group the same lifestyle intervention program as the group taking metformin. Because of this, it’s hard to tell how much the metformin might have been responsible for cutting the ultimate risk of Type 2 diabetes. We can only hope that researchers will now try to build on this study’s results to clarify this question.
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