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Metformin Prescription for Insured Adults With Prediabetes From 2010 to 2012
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Apr 21 2015
Source: Ann Intern Med. 162(8):542-548. -
Alternative Title:Ann Intern Med
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Description: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 mis-classification 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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Pubmed ID:25894024
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Pubmed Central ID:PMC4682357
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CDC-INFO
