Medication for Prediabetes: When Is It Necessary?

A prediabetes diagnosis may rattle your nerves, but it’s actually something to be grateful for: It’s an opportunity to take action and improve your health before you have full-blown diabetes.

“When patients find out they have prediabetes, they’re naturally concerned,” says Sonal Chaudhry, MD, an endocrinologist at NYU Langone Health in New York City. “They want to know what they can do to reduce their risk further.”

The first step to reducing the risk of diabetes includes key lifestyle changes. These are your basic recommendations that docs advise everyone, like exercising regularly and eating a balanced diet rich in fruits, veggies, and whole grains. (Learn more lifestyle tips to manage and prevent diabetes here.)

The goal is to reverse the development of insulin resistance, which is when the body stops responding to insulin and therefore does not absorb enough glucose from the bloodstream. (Here’s more information on how insulin resistance affects the body.) While lifestyle changes for prediabetes can help many patients, these changes alone sometimes won’t cut it.

Medication for prediabetes may supplement exercise and diet tweaks to keep diabetes from progressing. Doctors may prescribe medication for prediabetes patients with the following criteria, according to Dr. Chaudhry.

• Being overweight or obese

• An A1C level greater than 6

• A history of gestational diabetes

A common medication for managing prediabetes is metformin, which makes the body more sensitive to insulin, according to Minisha Sood, MD, an endocrinologist in New York City. This medication acts on the liver and muscles to decrease the amount of glucose taken in from food and made by the liver. By reducing glucose, says Dr. Sood, the body can use insulin more effectively, thus preventing type 2 diabetes.

The takeaway? If you’ve been diagnosed with prediabetes, you have options. You are not “doomed” to develop diabetes. While medication for prediabetes can help, your best tools are diet, exercise, and weight loss, according to the American Heart Association.

“Prediabetes means it can be reversed,” says Sandra Arévalo, RDN, a spokesperson for the American Association of Diabetes Educators. “Prediabetes is giving you the opportunity to make some changes and work on avoiding the diagnosis of diabetes.”