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Safe, efficacious metformin rarely prescribed for diabetes prevention among working-age adults
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Metformin has been shown to be safe and effective for diabetes prevention, but it is rarely prescribed among working-age adults, according to recent study findings published in the Annals of Internal Medicine.
“The 2002 Diabetes Prevention Program study showed that both lifestyle intervention and metformin lower diabetes risk compared to placebo, but little is known about efforts to translate metformin use for diabetes prevention,” Tannaz Moin, MD, MBA, MSHS, of the David Geffen School of Medicine at the University of California, Los Angeles, told Endocrine Today. “Our study shows that metformin is rarely prescribed for diabetes prevention, despite being a safe and evidence-based treatment option."
Tannaz Moin
Moin and colleagues conducted a retrospective cohort analysis of 17,352 adults aged 19 to 58 years with prediabetes continuously insured through United Healthcare between 2010 and 2012. Researchers aimed to determine the rate of metformin prescriptions among this population.
During the study, 3.7% of participants had a prescription for metformin. In the subsets of patients with a BMI more than 35 kg/m2 (n = 391) or gestational diabetes (n = 121), there was a 7.8% prevalence of metformin prescriptions.
Using adjusted predicted probability, the researchers found that women were nearly twice as likely (4.8%) as men (2.8%) to have a prescription for metformin (P < .001). This was similar in participants with obesity (6.6%) and those without (3.5%; P < .001). Participants with two or more comorbid conditions were nearly 1.5 times more likely to have a metformin prescription (4.2%) compared with participants without any comorbid conditions (2.8%; P = .001).
“Our findings highlight a real opportunity to enhance translation of national diabetes prevention efforts for large portions of the U.S. adult population estimated to have prediabetes, particularly among those at highest risk (less than 60 years of age, with history of gestational diabetes or BMI > 35 kg/m2,” Moin said. “Patients with prediabetes should be educated about all evidence-based treatment options for diabetes prevention and their relative risks vs. benefits in order to make the treatment decision that best aligns with their preferences and levels of risk.” – by Amber Cox
Disclosure: Moin reports various financial ties with the CDC, NIH, NIDDK and VA Office of Academic Affiliations. Please see the full study for a list of all other authors’ relevant financial disclosures.
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