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Cited by 248Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Treatment and ManagementMetabolism, Diabetes, and Cancer

Meta-analysis: metformin treatment in persons at risk for diabetes mellitus

Salpeter, Shelley R., Buckley, Nicholas S., Kahn, Justin A., Salpeter, Edwin E.·2008·The American Journal of Medicine
DOI 10.1016/j.amjmed.2007.09.016
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Abstract

Purpose We performed a meta-analysis of randomized controlled trials to assess the effect of metformin on metabolic parameters and the incidence of new-onset diabetes in persons at risk for diabetes.Methods We performed comprehensive English- and non-English-language searches of EMBASE, MEDLINE, and CINAHL databases from 1966 to November of 2006 and scanned selected references. We included randomized trials of at least 8 weeks duration that compared metformin with placebo or no treatment in persons without diabetes and evaluated body mass index, fasting glucose, fasting insulin, calculated insulin resistance, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and the incidence of new-onset diabetes.Results Pooled results of 31 trials with 4570 participants followed for 8267 patient-years showed that metformin reduced body mass index (-5.3%, 95% confidence interval [CI], -6.7--4.0), fasting glucose (-4.5%, CI, -6.0--3.0), fasting insulin (-14.4%, CI, -19.9--8.9), calculated insulin resistance (-22.6%, CI, -27.3--18.0), triglycerides (-5.3%, CI, -10.5--0.03), and low-density lipoprotein cholesterol (-5.6%, CI, -8.3--3.0%), and increased high-density lipoprotein cholesterol (5.0%, CI, 1.6-8.3) compared with placebo or no treatment. The incidence of new-onset diabetes was reduced by 40% (odds ratio 0.6; CI, 0.5-0.8), with an absolute risk reduction of 6% (CI, 4-8) during a mean trial duration of 1.8 years.Conclusion Metformin treatment in persons at risk for diabetes improves weight, lipid profiles, and insulin resistance, and reduces new-onset diabetes by 40%. The long-term effect on morbidity and mortality should be assessed in future trials.

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  • Metformin has beneficial effects on BMI and lipid levels and has been proven safe based on trial evidence showing no serious adverse effects, only minor gastrointestinal side effects.

    “Metformin, used for decades to treat diabetes, has beneficial effects on BMI and lipid levels and has been proven to be safe based on trial evidence showing that there were no serious adverse effects (only minor gastrointestinal side effects were detected).94”

    From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [94]

  • In a meta-analysis of randomized controlled trials, Salpeter et al. reported a 40% reduction in incidence of new-onset diabetes with an absolute risk reduction of 6% (95% CI 4-8) during a mean trial duration of 1.8 years.

    “In a meta-analysis of randomized controlled trials, Salpeter et al. reported a reduction of 40% in the incidence of new-onset diabetes with an absolute risk reduction of 6% (95% CI, 4–8) during a mean trial duration of 1.8 years [14].”

    From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [14]

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Authors
Salpeter, S. R., Buckley, N. S., Kahn, J. A., & Salpeter, E. E.
Affiliations
  • Santa Clara Valley Medical Center (US)
  • Cornell University (US)
Corresponding author
Salpeter, Shelley R.
Venue
The American Journal of Medicine
Publisher
Elsevier BV
Published
2008-02
Volume
121
Issue
2
Pages
149-157.e2
ISSN
0002-9343 (ISSN-L)
DOI
10.1016/j.amjmed.2007.09.016
OpenAlex
W2095048951
Cited by
248
References
106
Citations by year
2026: 4 · 2025: 8 · 2024: 5 · 2023: 11 · 2022: 9 · 2021: 10 · 2020: 19 · 2019: 18 · 2018: 15 · 2017: 18 · 2016: 23 · 2015: 21 · 2014: 17 · 2013: 13 · 2012: 12
FWCI
2.08
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The American Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
Keywords
metformin, prediabetes, diabetes prevention, new-onset diabetes, insulin resistance, fasting blood glucose, fasting insulin, lipid profile, body mass index, triglycerides, HDL cholesterol, LDL cholesterol
MeSH terms
Adult, Blood Glucose, Diabetes Mellitus, Humans, Hypoglycemic Agents, Insulin Resistance, Lipoproteins, Metformin, Middle Aged, Risk Factors, Body Mass Index, Prevalence, Treatment Outcome

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