Objectives:
Prediabetes is characterized by elevation of indices of
blood glucose that is insufficient to provoke a diagnosis of
type 2 diabetes, but markedly increases the risk of developing
type 2 diabetes in the future. Lifestyle interventions are the main therapeutic intervention for the management of
prediabetes. Current guidelines also support treatment of
prediabetes with
metformin for selected subgroups of patients, and
metformin has a therapeutic indication for this use in a number of countries.Methods: We performed an observational, non-interventional study of the effects on glycaemia of prolonged-release
metformin (
Glucophage XR, referred to henceforth as
metformin XR) in 686 subjects with
prediabetes.
Metformin was prescribed according to physicians' usual care practices, and the study duration was 12 weeks.Results: Mean (SD) fasting plasma
glucose (FPG) at baseline was 6.2 (0.4) mmol/L [111 (8) mg/dL) and was reduced by -0.55 (0.7) mmol/L [-10 (13) mg/dL] after 12 weeks of
metformin XR. FPG was normalized to below the American Diabetes Association cut-off for the diagnosis of
prediabetes (<5.7 mmol/L [100 mg/dL]) in 43% of subjects. Increasing age, increasing body mass index, not following a
weight-loss diet and alcohol use predicted a lower probability of normalized FPG.
Metformin was well tolerated, with most side effects occurring in the gastrointestinal system, as expected.Conclusions:
Metformin XR normalized FPG in about two-fifths of subjects with
prediabetes. These real-world data add further support a role for
metformin in the management of
prediabetes, in line with current guidelines in this area.