Doctors say metformin aids prediabetes

Indian Express reported on May 14 that doctors may prescribe metformin for some people with prediabetes, citing Mumbai endocrinologist Dr. Pranav Ghody’s explanation of how the drug works and when it should be stopped. Ghody told the newspaper that metformin improves insulin sensitivity and reduces excess glucose production by the liver in patients whose blood sugar is above normal but not yet in the diabetes range. He said the drug can help delay or prevent progression to type 2 diabetes when it is used alongside diet, exercise and weight management. U.S. health agencies and diabetes groups separately describe prediabetes as a high-risk state in which blood glucose is elevated and say lifestyle changes remain central to prevention or delay of type 2 diabetes. ### Who did the Indian Express quote, and what did he say? Dr. Pranav Ghody, a consultant endocrinologist and diabetologist at Wockhardt Hospitals in Mumbai Central, told Indian Express that prediabetes reflects early insulin resistance rather than established diabetes. He said metformin helps the body use insulin more effectively and lowers the liver’s production of extra glucose. (indianexpress.com) The May 14 article said Ghody identified higher-risk patients as those who are overweight, have a strong family history or show rising HbA1c levels. He said metformin can “slow or even prevent” progression to type 2 diabetes in such patients when paired with lifestyle changes. ### What exactly is prediabetes? (indianexpress.com) The National Institute of Diabetes and Digestive and Kidney Diseases says prediabetes means blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. The agency says insulin resistance is a condition in which the body does not respond to insulin the way it should, and that persistent increases in blood glucose can lead to type 2 diabetes. (indianexpress.com) NIDDK said about 97.6 million U.S. adults age 18 and older had prediabetes in 2021. The agency lists overweight or obesity, age 35 or older, family history of diabetes, physical inactivity, prior gestational diabetes and some other conditions among the factors linked to higher risk. ### Why is metformin used before someone has diabetes? (niddk.nih.gov) The Diabetes Prevention Program Outcomes Study says the original Diabetes Prevention Program showed that lifestyle changes or metformin could delay diabetes in overweight or obese adults at high risk, compared with placebo. That finding underpins the use of metformin in selected people with prediabetes, especially when clinicians judge the risk of progression to be high. (niddk.nih.gov) The American Diabetes Association’s 2026 Standards of Care includes a section on “Prevention or Delay of Diabetes and Associated Comorbidities,” reflecting that prevention remains a formal part of diabetes care guidance. The issue table of contents does not by itself spell out patient-level prescribing criteria, but it confirms that prevention and delay of diabetes remain a current guideline category. (dppos.bsc.gwu.edu) ### Can someone stop metformin once glucose levels look normal? Ghody told Indian Express that normal glucose readings may reflect the combined effect of medication and lifestyle changes, not proof that the underlying tendency has disappeared. He said stopping metformin without medical advice can allow blood sugar to rise again. (diabetesjournals.org) The same article said the decision to reduce or stop the drug depends on consistent improvement, weight control and the patient’s overall risk profile. Ghody said any change should be made under medical supervision with regular monitoring. ### What matters besides medication? The Centers for Disease Control and Prevention says its National Diabetes Prevention Program is built around a yearlong lifestyle change program designed to help participants build lasting habits. (indianexpress.com) The CDC says the program is proven to cut type 2 diabetes risk in half. Ghody told Indian Express that medication is only one part of treatment and that regular physical activity, balanced meals, adequate sleep and stress management are essential in preventing progression. (indianexpress.com) NIDDK similarly says many people can take steps to prevent or delay prediabetes and type 2 diabetes by working with their health care team. (cdc.gov) ### What should readers watch for next? The May 14 Indian Express report points readers back to physician follow-up rather than a fixed stop date. Ghody said periodic follow-ups are needed to check tolerance, vitamin levels and overall metabolic health, and the CDC’s National DPP page lists in-person and remote lifestyle programs for people trying to reduce their risk. (indianexpress.com)