If you have been diagnosed with prediabetes, you may want to learn about the medications available to treat it.
Prediabetes is a condition in which your blood sugar levels are higher than normal but not high enough to be diabetes although it often can progress to diabetes.
There are several medications that can be used to treat prediabetes, including metformin, which is a medication that helps control blood sugar levels by decreasing the amount of glucose produced by the liver and increasing the sensitivity of cells to insulin.
In this article, we will discuss prediabetes, how metformin can treat it, and whether it is right for you.
What is prediabetes?
Prediabetes is a chronic condition that is identified by your blood sugar levels being higher than normal.
Your blood sugar, also called glucose, spikes because your body is unable to effectively use insulin. Insulin is a hormone that helps your body process and use glucose for energy.
When you have prediabetes, your body becomes less sensitive to insulin and becomes insulin resistant.
The insulin resistance allows your glucose to stay in your blood and not get used for energy which can lead to type 2 diabetes and a number of other health conditions such as cardiovascular disease, chronic kidney disease, heart attack, stroke, and kidney damage.
What are the symptoms of prediabetes?
Unless you test your blood glucose levels, you may not even know you have prediabetes as there usually are no symptoms.
If you do exhibit symptoms, they will most likely take the form of the common symptoms of diabetes. The most common symptoms of prediabetes include:
- Excessive thirst
- Excessive hunger
- Weight loss without any explanation even if you eat more food
- Dark, velvety, spots on your skin, especially on your neck, groin, armpits, knees, elbows, and knuckles
- Frequent urination
- Fatigue or tiredness
- Blurry vision
- Numbness or tingling in your hands and feet
- Slow-healing wounds
- Increased amounts of infections
If you have any of these symptoms please consult with your doctor or health care provider to ensure you do not have prediabetes or diabetes.
What are the causes and risk factors for prediabetes?
The cause of prediabetes is not fully understood; however, there are some risk factors that strongly correlate to getting prediabetes.
The common risk factors for prediabetes include:
- Family history of diabetes or prediabetes
- Sedentary lifestyle and lack of physical activity
- Being over the age of 45
- High blood pressure
- High levels of triglycerides in your blood
- Metabolic syndrome which is a group of symptoms that occur with obesity and can cause insulin resistance
- Unhealthy cholesterol levels (high LDL levels and low HDL levels)
- Being overweight and obese
- Having a waistline that is larger than 40 inches for men and 35 inches for women
- Smoking tobacco
- Having had gestational diabetes before
- Having an unhealthy diet that consists of red meat, processed foods, sugary drinks, and unhealthy fats
- Being a certain race or ethnicity as you are more likely to get prediabetes if you are African American, Asian American, Pacific Islander, Latino, or Native American
- Having polycystic ovary syndrome (PCOS)
- Having sleep apnea, which is a sleep disorder where you have disrupted breathing throughout the night
If you have some of these risk factors, it does not mean that you will get prediabetes but having one or more of them means you need to be tested for prediabetes so you can take steps to prevent the progression from prediabetes to diabetes or even reverse the condition.
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How is prediabetes diagnosed?
There are three common tests that are used for a prediabetes diagnosis which we will detail below.
Fasting plasma glucose (FPG) test
The first test is the fasting plasma glucose test.
The fasting plasma glucose test uses a blood sample to measure your blood sugar after you have not eaten or had anything to drink for at least eight hours.
A normal fasting blood sugar level is below 100 milligrams per deciliter (mg/dl). If your fasting blood sugar level is between 100-125 mg/dl, you have prediabetes.
Oral glucose tolerance test (OGTT)
The second test is the oral glucose tolerance test. The oral glucose tolerance test measures your blood sugar after you have fasted for at least eight hours and then drink a sugary drink.
A normal blood sugar level is below 140 mg/dl two hours after drinking the sugary drink. If your blood sugar level is between 140-199 mg/dl, you have prediabetes.
Glycated hemoglobin A1C test
The third and final test is the hemoglobin A1C test.
The hemoglobin A1C test measures your average blood sugar over the past three months.
A normal hemoglobin A1C level is below 5.7%. If your hemoglobin A1C level is between 5.7-6.4%, you have prediabetes.
If you receive a diagnosis of prediabetes, it is important to monitor your blood sugar levels and see your doctor regularly as prediabetes increases your risk for diabetes.
The complications of diabetes and prediabetes include heart disease, stroke, and other serious health conditions if it is not treated.
What are the treatment options for prediabetes?
The best way to treat prediabetes is by making lifestyle modifications which include eating a healthy diet, exercising regularly, quitting smoking, and losing any excess weight.
Living a healthy lifestyle will help you to control your blood sugar levels, help you lose any extra weight, and prevent the progression of prediabetes to full-blown diabetes.
If these lifestyle changes are not enough to control your prediabetes, then your doctor may prescribe medication.
The most common medication used to treat prediabetes is metformin.
What does metformin do for prediabetes?
Metformin is an oral medication that helps to lower your blood sugar levels by improving your body’s sensitivity to insulin and also inhibiting your body’s ability to make glucose.
Metformin works by decreasing the amount of glucose produced by your liver and also by making your cells more responsive to insulin so that your body can better glucose metabolism, which ultimately lowers your blood sugar levels.
What are the different types of metformin?
There are two different types of metformin, immediate-release and extended-release. Immediate-release metformin is taken multiple times a day usually with meals while extended-release metformin is only taken once a day with or without food.
The brand name for immediate release metformin is Glucophage while the extended-release versions can go by the brand names of Glumetza, Fortamet, and Glucophage.
All versions are also available as generic metformin too.
What are the side effects of metformin?
The most common side effects of metformin are diarrhea, nausea, gas, and vomiting.
These adverse effects usually go away after a couple of weeks as your body gets used to the medication.
If these side effects persist please talk to your doctor who may be able to switch you from an immediate-release version to an extended-release version.
Although you can take the metformin with a meal or on an empty stomach, it is recommended to take it during a meal or right after a meal to help with any gastrointestinal problems you may experience. Also, make sure to inform your doctor of any medications you are already taking before using metformin.
How long will I have to take metformin?
If you have prediabetes, you will likely have to take metformin for at least a year or even indefinitely.
However, prediabetes is reversible and if your blood sugar levels return to normal with lifestyle changes, metformin, or a combination of both, you may be able to eventually stop taking the medication.
It is important that you talk to your doctor about how long you will need to take metformin and if there are any other options for you.
Is metformin right for me?
The decision to start metformin for prediabetes needs to be made between you and your doctor.
Remember to take into consideration the potential side effects of metformin as well as the risks associated with prediabetes and type 2 diabetes.
If you have prediabetes, it is important to monitor your blood sugar levels and see your doctor regularly as prediabetes can lead to type 2 diabetes.
Summary
Prediabetes is a condition where you have higher than normal amounts of glucose levels and is often a precursor to type 2 diabetes.
There usually are no symptoms if you have prediabetes although sometimes there may be symptoms similar to those of type 2 diabetes. Treatment options for prediabetes are typically lifestyle changes including diet, exercise, and losing any excess body weight.
If these changes do not improve your prediabetes, then your doctor may prescribe medication such as metformin. Metformin is an oral medication that improves insulin sensitivity and lowers the amount of glucose produced by your liver.
There are two types of metformin, immediate-release and extended-release, and the side effects of metformin are usually gastrointestinal such as diarrhea, nausea, gas, and vomiting.
You will likely have to take metformin for at least a year or even indefinitely if you have prediabetes unless you lower your blood sugar level to normal levels.
Please talk to your doctor or health care provider if you have any more questions about prediabetes or whether metformin is right for you.
References and sources:
Mayo Clinic
WebMD
GoodRx Health
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