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Many individuals who are recently diagnosed with pre-diabetes frequently question why they are also given Metformin, a medication commonly recommended for managing diabetes in India. A user on Quora asked about this matter. "Why do doctors suggest Metformin for pre-diabetes if it is also used later for diabetes?" To provide accurate information, we consulted specialists.
Metformin is one of the most researched medications for managing diabetes. “It is primarily recognized as the first treatment for type 2 diabetes, but studies indicate it also benefits pre-diabetes. The explanation is simple: pre-diabetes indicates that blood sugar levels are elevated, but not enough to be classified as diabetes. Starting Metformin early for some patients can postpone or even avert the onset of full diabetes,” explained Dr. Pranav Ghody, a consultant endocrinologist and diabetologist at Wockhardt Hospitals in Mumbai Central.
Though Metformin is predominantly associated with diabetes, its early application in pre-diabetes addresses the same root issue of insulin resistance. “By tackling this concern sooner, Metformin can slow down the progression of the disease and reduce the chance of complications. This forward-thinking strategy makes Metformin an important resource in the management of both pre-diabetes and diabetes, as it aids in maintaining better long-term blood sugar levels,” stated Kanikka Malhotra, a consultant dietician and diabetes educator.
It is important to note that Metformin has been in use in India for many years and belongs to a category of medicines known as biguanides. “Unlike many other medications, Metformin does not stimulate increased insulin production; it instead aids the body's insulin to function more effectively,” mentioned Dr. Ghody. It achieves this by decreasing sugar output from the liver and enhancing insulin sensitivity in muscle and fat cells. Dr. Ghody indicated that doctors typically recommend it for individuals who are overweight, under the age of 60, have a strong family history of diabetes, or women diagnosed with polycystic ovary syndrome (PCOS). “For those in these high-risk categories, merely making lifestyle changes might not suffice, and Metformin offers additional protection,” Dr. Ghody added.
What should individuals consider before beginning Metformin?
Start with lifestyle changes: Proper diet, exercise, and weight control serve as the foundation. “Metformin is generally prescribed when risks are elevated or when lifestyle adjustments don’t suffice,” noted Dr. Ghody.
Tolerance: Most individuals handle it well, though some may initially feel stomach discomfort. “Taking it with meals can help minimize side effects,” Dr. Ghody advised.
Safety: It is usually safe, but kidney function should be evaluated before starting and consistently monitored.
Not an excuse: Metformin does not give the green light to eat anything. It is most effective when combined with healthy practices, according to Dr. Ghody.
For an individual with pre-diabetes, taking Metformin typically involves a commitment of multiple years, often around three, but this may differ based on the individual’s response to the medication and lifestyle adjustments, explained Malhotra. “Many begin with a low dosage and only raise it if required, which helps in managing potential side effects, such as stomach discomfort,” Malhotra noted.
The important thing to realize is that Metformin is not a fast solution—it acts like a supportive companion to nutritious eating and consistent physical activity. Malhotra explains that physicians keep track of progress frequently to determine when or if the medicine can be lowered or discontinued. “For certain individuals, adopting positive lifestyle habits can even turn around prediabetes, decreasing the necessity for medication as time passes. Thus, it is a long-range, supportive method rather than merely a temporary pill,” Malhotra stated.
