Metformin Therapy for Prediabetes

Introduction to Metformin Therapy

• The American College of Physicians, as published in the Annals of Internal Medicine, suggests that metformin is generally well-tolerated, low-cost, and not associated with hypoglycemia, making it a reasonable pharmacologic option for patients with prediabetes 1

Monitoring and Follow-up

• The American Diabetes Association, as published in Diabetes Care, recommends monitoring A1c every 3 months to assess response to therapy 2
• The American Diabetes Association, as published in Diabetes Care, suggests considering periodic testing of vitamin B12 levels during long-term metformin therapy 3
• If A1c normalizes (<5.7%), the Annals of Internal Medicine suggests considering de-intensifying therapy 1
• If A1c progresses to diabetes range (≥6.5%), Diabetes Care recommends reassessing treatment strategy and considering additional therapies 3