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Diabetes

IMPAIRED GLUCOSE TOLERANCE and metformin

12/08/2008

Question:

Sir, I am male/51 years and hypertnsive. Recently, I had check up and my Glucose tolerance test which stated IMPAIRED GLUCOSE TOLERANCE. My internist suggested to take Metformin 250 mg. Is this really needed or am I diabetic I am obese Taking Tenormin 100 Indapamide 1.5 Losartan 100 Amlodepine 10 mg Normal lipids No thyroid No cardiac problems Rest of the parameters normal. Request you Sir to guide me.

Answer:

One of the main pieces of evidence supporting your doctor in this decision was the type 2 diabetes prevention program (see reference below).  According to this study, people who were at risk for developing type 2 diabetes as defined by having impaired glucose tolerance had the rate of proceeding to type 2 diabetes reduced by treatment with metformin.  The thinking behind this approach was that slowing the progression to type 2 diabetes should slow the rate of development of the complications of diabetes.  So there is a good scientific rationale for this recommendation.  Some doctors use this approach and some do not - everything in medicine is a really a judgement, not "written in stone" for all.

Reference: The Diabetes Prevention Program Research Group: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393-403, 2002

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati