Research
Hormonal
Metformin reduces the risk of progression from prediabetes to type 2 diabetes by enhancing insulin action in the liver and skeletal muscle, with efficacy approaching that of intensive lifestyle intervention in younger, higher-BMI, or higher-FPG subgroups.
If you have prediabetes, metformin is a proven, safe, and low-cost option to delay or prevent type 2 diabetes. It works best if you are younger, overweight, or have higher fasting glucose. It should be used alongside lifestyle changes, not as a replacement, and requires a prescription.
StrongSupportsVERY_HIGH confidence
Metformin enhances the action of insulin in liver and skeletal muscle, and its efficacy for delaying or preventing the onset of diabetes has been proven in large, well-designed, randomised trials... The efficacy of metformin approached that of the intensive lifestyle intervention in younger subjects and those with higher BMI or FPG at baseline.
Why this rating
Supported by large, well-designed RCTs (DPP, IDPP, CANOE) and long-term follow-up (DPPOS).
Source
Therapeutic Use of Metformin in Prediabetes and Diabetes Prevention
Ulrike Gottwald‐Hostalek et al. · Drugs · 2015
DOI 10.1007/s40265-015-0416-8
narrative_reviewCited 273×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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