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Metformin in prediabetes

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Metformin in Prediabetes

NICE suggest that a clinician should use clinical judgement on whether (and when) to offer metformin to support lifestyle change for people whose HbA1c or fasting plasma glucose blood test results have deteriorated if:

  • this has happened despite their participation in intensive lifestyle-change programmes or
  • they are unable to participate in an intensive lifestyle-change programme, particularly if they have a BMI greater than 35

Check renal function before starting treatment, and then twice yearly (more often if they are older or if deterioration is suspected).

Dose:

  • start with a low dose (for example, 500 mg once daily) and then increase gradually as tolerated, to 1500–2000 mg daily. If the person is intolerant of standard metformin consider using modified-release metformin

Duration:

  • prescribe metformin for 6-12 months initially. Monitor the person's fasting plasma glucose or HbA1c levels at 3-month intervals and stop the drug if no effect is seen (1).

Reference:

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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