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Metformin use low in adults with prediabetes
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Metformin use among adults with prediabetes is relatively low and only slightly more common in those with additional diabetes risk factors, study data show.
Eva Tseng, MD, MPH, of the division of general internal medicine at Johns Hopkins University, and colleagues evaluated data from the National Health and Nutrition Examination Survey 2005-2012 on 7,652 adults with prediabetes to determine the prevalence and characteristics associated with metformin use.
Overall, 91 participants were prescribed only metformin and 7,561 were not prescribed any diabetes medications for an age-adjusted prevalence of metformin use of 0.7%. Higher mean BMI (P < .01) and higher glucose (fasting glucose, P = .03; HbA1c 6%, P < .01; 2-hour poststimulation glucose, P = .003) were found among participants prescribed metformin compared with those without a prescription. An HbA1c of at least 6% was more likely in participants prescribed metformin (51%) compared with participants without a prescription (14.5%; P < .001). Having an HbA1c of at least 6% vs. less than 6% (adjusted OR = 4.56; 95% CI, 2.48-8.37) and being informed of overweight status by a physician (adjusted OR = 3.27; 95% CI, 1.68-6.37) were more likely among participants prescribed metformin compared with those without a prescription in the multivariable model. Participants prescribed metformin were likely to meet more than one criterion for prediabetes, including fasting glucose, HbA1c or 2-hour poststimulation plasma glucose.
Compared with participants prescribed metformin who had BMI less than 35 kg/m2, participants prescribed metformin with BMI of at least 35 kg/m2 were likely to be white, have a smaller poverty-to-income ratio and have lower mean HbA1c and fasting glucose. Adults prescribed metformin were more likely to have health insurance coverage (P < .01) and comorbid conditions (P = .02) compared with participants not on metformin; however, this was not significant after multivariable adjustment.
“We found that the vast majority of U.S. adults with prediabetes, including those at high risk of developing diabetes, do not report use of metformin as preventive pharmacotherapy,” the researchers wrote. “Metformin is an effective, safe and low-cost preventive pharmacotherapy option for patients with prediabetes. Ongoing efforts to reduce the risk of type 2 diabetes through intensive lifestyle changes are important but must be augmented by other approaches. Further study on how to implement metformin as a preventive intervention for type 2 diabetes is needed to truly stem the tide of the diabetes epidemic.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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