Metformin for diabetes prevention: Update of the evidence base

Curr Med Res Opin. 2021 Jul 20:1. doi: 10.1080/03007995.2021.1955667. Online ahead of print.ABSTRACTWe have conducted a narrative review based on a structures search strategy, focussing on the effects of metformin on the progression of non-diabetic hyperglycaemia to clinical type 2 diabetes mellitus. The principal trials that demonstrated a significantly lower incidence of diabetes in at-risk populations randomised to metformin (mostly with impaired glucose tolerance [IGT]) were published mainly from 1999 to 2012. Metformin reduced the 3-year risk of diabetes by -31% in the randomised phase of the Diabetes Prevention Program (DPP), versus -58% for an intensive lifestyle intervention (ILI). Metformin was most effective in younger, heavier subjects. Diminishing but still significant reductions in diabetes risk for subjects originally randomised to these groups were present in the trial's epidemiological follow-up, the DPP Outcomes Study (DPPOS) at 10 years (-18% and -34%, respectively), 15 years (-18% and -27%) and 22 years (-18% and -25%). Long-term weight loss was also seen in both groups, with better maintenance under metformin. Subgroup analyses from the DPP/DPPOS have shed important light on the actions of metformin, including a greater effect in women with prior gestational diabetes, and a reduction in coronary artery calcium in men that might suggest a cardioprotective effect. Improvements in long-term clinical outcomes with metformin in people with non-diabetic hypergly...
Source: Current Medical Research and Opinion - Category: Research Authors: Source Type: research