Why Is This Prediabetes Treatment Being Underused?
A recent study has found only 3.7% of adults with prediabetes were prescribed metformin during a recent 3-year period. Findings from the study are published in the Annals of Internal Medicine.
Researchers from the David Geffen School of Medicine at UCLA and at VA Greater Los Angeles reported that few doctors are prescribing metformin, which has been shown to prevent the onset of diabetes. In 2008, metformin was added to the American Diabetes Association's "Standards for Medical Care in Diabetes" guidelines for use as prevention in patients at very high risk who are <60 years old, severely obese, or have a history of gestational diabetes. Metformin could also be considered for those with above normal blood sugar but not in the diabetes range.
In the study, the team analyzed data from 2010-2012 from UnitedHealthcare of 17,352 adults aged 18–58 years with prediabetes. Some of the findings include:
- The prevalence of metformin prescriptions was 7.8% for severely obese patients.
- Metformin prescriptions were nearly twice as high for women (4.8%) as for men (2.8%).
- Among people with prediabetes, the prevalence of prescriptions for obese individuals was 6.6% vs. 3.5% for non-obese people.
- Among people who had prediabetes and two other chronic diseases, 4.2% received prescriptions for metformin vs. 2.8% of people with prediabetes and no other chronic diseases.
Key factors such as the lack of metformin's FDA approval for prediabetes, and reluctance by patients and doctors to "medicalize" prediabetes may be reasons why metformin may be underused. A lack of knowledge of the 2002 Diabetes Prevention Program Study, which showed lifestyle changes and metformin can prevent or delay progression to diabetes among those with prediabetes, may also be a reason why metformin is not as utilized. Researchers concluded that coming up with more ways to help patients avoid diabetes is necessary for individuals' lives and to society.
For more information visit uclahealth.org.