Therapeutic Use of Metformin in Prediabetes and Diabetes Prevention

摘要: People with elevated, non-diabetic, levels of blood glucose are at risk progressing to clinical type 2 diabetes and commonly termed ‘prediabetic’. The term prediabetes usually refers high–normal fasting plasma (impaired glucose) and/or 2 h following a 75 g oral tolerance test tolerance). Current US guidelines consider HbA1c also represent prediabetic state. Individuals dysglycaemia already elevated damage the microvasculature macrovasculature, resembling long-term complications diabetes. Halting or reversing progressive decline in insulin sensitivity β-cell function holds key achieving prevention at-risk subjects. Lifestyle interventions aimed inducing weight loss, pharmacologic treatments (metformin, thiazolidinediones, acarbose, basal drugs for loss) bariatric surgery have all been shown reduce progression However, lifestyle difficult patients maintain loss achieved tends be regained over time. Metformin enhances action liver skeletal muscle, its efficacy delaying preventing onset has proven large, well-designed, randomised trials, such as Diabetes Prevention Program other studies. Decades use demonstrated that metformin is generally well-tolerated safe. We reviewed detail evidence base supporting therapeutic prevention.