Metformin Prescription Rates for Patients with Prediabetes.

PURPOSE

Prediabetes is a serious public health concern, with 34.5% of US adults meeting the criteria for prediabetes. The American Diabetes Association has highlighted metformin therapy as a consideration for individuals with BMI 35 kg/m, those aged 60 years, and women with a history of gestational diabetes. We examined metformin prescription rates among a national sample of commercially insured, higher risk patients with prediabetes.

METHODS

We gathered 2012 to 2018 demographic, laboratory, and prescription data for 53,551 patients with prediabetes from the IBM MarketScan research database. Our primary outcome was metformin prescription rates 1 or 3 years after a laboratory confirmation of prediabetes among patients who have a BMI 35 kg/m or are aged 60 years.

RESULTS

Overall, 2.4% (n = 1,124) of patients received a metformin prescription within 1 year of a laboratory confirmed prediabetes result, including 2.4% of patients aged 60 years and 10.4% of those with BMI 35 kg/m. By a 3 year follow-up, 4.1% (n = 1901) received a metformin prescription, including 3.9% of patients aged 60 years and 14.0% with BMI 35 kg/m. Patients who developed type 2 diabetes within the 1 (n = 2,769) or 3 year (n = 7,268) follow-up periods were excluded from analysis.

CONCLUSIONS

Few prediabetes patients who were either obese or aged 60 years received a metformin prescription between 2012 and 2018. Prescription rates increased slightly between 1 and 3 years after a prediabetes diagnosis, so strategies to support timely intervention among higher risk patients with prediabetes are critically needed.