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Cited by 90Diabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and Research

Metformin Prescription for Insured Adults With Prediabetes From 2010 to 2012: A Retrospective Cohort Study

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Moin, Tannaz, Li, Jinnan, Duru, O. Kenrik, Ettner, Susan, Turk, Norman, Keckhafer, Abigail, Ho, Sam, Mangione, Carol M.·2015·Annals of Internal Medicine
DOI 10.7326/m14-1773PMC PMC4682357
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Abstract

BACKGROUND: Prediabetes affects 1 in 3 Americans. Both intensive lifestyle intervention and metformin can prevent or delay progression to diabetes. Over the past decade, lifestyle interventions have been translated across various settings, but little is known about the translation of evidence surrounding metformin use. OBJECTIVE: To examine metformin prescription for diabetes prevention and patient characteristics that may affect metformin prescription. DESIGN: Retrospective cohort analysis over a 3-year period. SETTING: Employer groups that purchased health plans from the nation's largest private insurer. PARTICIPANTS: A national sample of 17 352 working-age adults with prediabetes insured for 3 continuous years between 2010 and 2012. MEASUREMENTS: Percentage of health plan enrollees with prediabetes who were prescribed metformin. RESULTS: Only 3.7% of patients with prediabetes were prescribed metformin over the 3-year study window. After adjustment for age, income, and education, the predicted probability of metformin prescription was almost 2 times higher among women and obese patients and more than 1.5 times higher among patients with 2 or more comorbid conditions. LIMITATION: Missing data on lifestyle interventions, possible misclassification of prediabetes and metformin use, and inability to define eligible patients exactly as defined in the American Diabetes Association guidelines. CONCLUSION: Evidence shows that metformin is rarely prescribed for diabetes prevention in working-age adults. Future studies are needed to understand potential barriers to wider adoption of this safe, tolerable, evidence-based, and cost-effective prediabetes therapy. PRIMARY FUNDING SOURCE: Centers for Disease Control and Prevention (Division of Diabetes Translation) and the National Institute of Diabetes and Digestive and Kidney Diseases.

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  • Previous studies examining metformin prescriptions have also found low prescribing rates.

    “Previous studies examining metformin prescriptions have also found low prescribing rates.”

    From Metformin Prescription Rates for Patients with Prediabetes (2022) · cites this paper as [16]

  • This practice of low metformin prescribing has changed very little in real-world settings up to 2018.

    “Our study shows this practice has changed very little in realworld settings up to 2018. 12,16”

    From Metformin Prescription Rates for Patients with Prediabetes (2022) · cites this paper as [16]

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  1. [6]Ramachandran A Snehalatha C Mary S Mukesh B Bhaskar AD Vijay V Indian Diabetes Prevention Programme (IDPP) The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1) Diabetologia 2006 49 289 97 16391903
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Authors
Moin, T., Li, J., Duru, O. K., Ettner, S., Turk, N., Keckhafer, A., Ho, S., & Mangione, C. M.
Affiliations
United States Department of Veterans Affairs (US)
ORCID
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
2015-04-21
Volume
162
Issue
8
Pages
542-548
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/m14-1773
PMC
PMC4682357
OpenAlex
W2017125704
Cited by
90
References
10
Citations by year
2026: 3 · 2025: 5 · 2024: 5 · 2023: 5 · 2022: 8 · 2021: 12 · 2020: 6 · 2019: 8 · 2018: 11 · 2017: 16 · 2016: 8 · 2015: 3
FWCI
11.01
Type
journal article
Language
en
Open access
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institutes of Health (UL1TR000124)
  • Centers for Disease Control and Prevention
  • National Institute on Aging (K08-AG033360, P30AG021684)
  • National Center for Chronic Disease Prevention and Health Promotion (U58 DP002722, U58DP002722-05)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
metformin, prediabetes, diabetes prevention, prescribing patterns, health insurance beneficiaries, employer-sponsored health insurance, lifestyle intervention, obesity, comorbidities, sex differences, barriers to prescribing
MeSH terms
Adult, Diabetes Mellitus, Female, Humans, Hypoglycemic Agents, Insurance, Health, Life Style, Male, Metformin, Middle Aged, Obesity, Prediabetic State, Retrospective Studies, Sex Factors, United States, Young Adult

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