Authors: Ulrike Hostalek, Svetlana Mustafina.
Aim: To study the effects of metformin in prediabetes.
Methods: This was an observational, non-interventional, uncontrolled study of the effects of the immediate-release formulation of metformin in 551 people with pre-diabetes, according to diagnostic criteria from the American Diabetes Association (ADA).
Results: The study population was predominantly female (66%), and on average was middle-aged (mean age 54 [SD 12] years) and obese (mean body mass index 32 kg/m2 [SD 6]) at baseline. Treatment with metformin for 12 weeks was associated with a mean reduction in fasting plasma glucose (FPG) of –0.8 mmol/L (95%CI –0.8 to –0.9) from a baseline value of 6.3 mmol/L (SD 0.5). FPG was normalised, according to ADA criteria (<5.6 mmol/L) in 86% of the population, at 12 weeks (the primary endpoint of the study). Reductions from baseline were also seen for HbA1c (by –0.4% [95% CI -0.3 to -0.5]) and post-load glucose following an oral glucose tolerance test (by –2.0 mmol/L [95%CI -1.5 to -2.4]) at 12 weeks. These parameters were normalised according to ADA criteria in a majority of patients where data were available, although measurements were available from only 189 and 51 patients, respectively. A logistic regression analysis suggested significant influence of age and starting dose of metformin on the likelihood of normalisation of FPG. Adherence to metformin was high (>75% in 93% of the population). Metformin was well tolerated, with common finding of mild-to-moderate gastrointestinal side-effects, as expected.
Conclusion: These real-world data add further evidence in support for a role for metformin in the management ofpeople with prediabetes.
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