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Meta-analysis: Metformin Treatment in Persons at Risk for Diabetes Mellitus
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, 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]
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“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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Metadata
- 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)
- 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
- 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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