Prediabetes is a health condition where blood sugar levels are elevated above normal, but not yet high enough for a type 2 diabetes diagnosis. It indicates an increased risk of developing type 2 diabetes. Metformin, a medication for managing type 2 diabetes, is also considered for prediabetes. Many wonder if metformin is a standard treatment.
Understanding Prediabetes
Prediabetes means blood glucose levels are higher than healthy levels but below the threshold for a type 2 diabetes diagnosis. This condition typically has no distinct symptoms, making regular screening important. Diagnosis relies on specific blood tests. An A1C test, reflecting average blood sugar over two to three months, indicates prediabetes with levels between 5.7% and 6.4%. Fasting plasma glucose tests show prediabetes with levels between 100 to 125 mg/dL. An oral glucose tolerance test (OGTT) result between 140 to 199 mg/dL after two hours also signifies prediabetes.
Addressing prediabetes is important due to its heightened risk of progressing to type 2 diabetes. Without intervention, this can lead to long-term health complications. These include damage to the heart, blood vessels, and kidneys, along with increased risks for heart attack, stroke, and nerve damage. Prediabetes is also associated with high blood pressure and abnormal cholesterol levels.
Metformin for Prediabetes Management
While lifestyle adjustments are generally the initial approach for prediabetes, metformin (metformin hydrochloride) can be prescribed in specific circumstances. Healthcare providers may consider this medication for individuals at high risk of developing type 2 diabetes. This includes those under 60 or with a body mass index (BMI) of 35 kg/m² or higher. Women with a history of gestational diabetes are also considered.
Metformin influences how the body manages glucose. It primarily reduces glucose produced by the liver. The medication also decreases glucose absorption from the intestines and enhances the body’s sensitivity to insulin. This improved insulin sensitivity allows cells to use glucose more effectively for energy. The decision to prescribe metformin for prediabetes is always made individually by a healthcare professional, weighing benefits against personal circumstances.
Lifestyle as the Primary Approach
For most people with prediabetes, lifestyle modifications are the most effective strategy to prevent or delay type 2 diabetes. These changes improve insulin sensitivity and help regulate blood glucose levels. Even if metformin is prescribed, these interventions remain a fundamental part of the management plan.
Healthy eating patterns are foundational, focusing on a balanced diet rich in fruits, vegetables, and whole grains. Limiting processed foods, sugary drinks, and added sugars is recommended. Portion control and choosing fiber-rich foods, lean proteins, and healthy fats contribute to better blood sugar management.
Regular physical activity is another component, with recommendations including at least 150 minutes of moderate-intensity aerobic exercise per week (e.g., brisk walking) or 75 minutes of vigorous activity. Incorporating muscle-strengthening exercises at least twice a week is also beneficial. Achieving and maintaining a healthy weight, including losing 5% to 7% of body weight, can reduce the risk of type 2 diabetes progression.
What to Know About Metformin Use
Individuals prescribed metformin should be aware of its potential effects and how to manage them. Common side effects involve gastrointestinal issues like nausea, diarrhea, stomach discomfort, and reduced appetite. These are most noticeable when first starting the medication and often diminish over time. Taking metformin with food can help mitigate these disturbances, and starting with a low, gradually increased dose may also lessen symptoms.
Less common but serious considerations include lactic acidosis, though this complication is rare. Symptoms of lactic acidosis require immediate medical attention. Metformin can also lead to a vitamin B12 deficiency with long-term use, so healthcare providers may monitor B12 levels. Regular monitoring by a healthcare provider, including periodic blood tests and A1C checks, is important to assess effectiveness and monitor for side effects. Adhering to the prescribed dosage and understanding that metformin is part of a broader management plan, not a standalone solution, is important for optimal outcomes.