Date of Award


Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies

First Advisor

Jeanie McHugo


prediabetes, metformin in prediabetes, lifestyle modifications and prediabetes, and prevention of diabetes.


The purpose of this literature review is to explore metformin’s role in the treatment of patients with prediabetes within the primary care setting. The efficacy of metformin versus lifestyle modifications will be compared as well as metformin, as adjunctive therapy, to lifestyle modifications. Along with efficacy, a systematic analysis will examine the three abovementioned therapies regarding diabetes risk reduction. Lastly, this review will examine the safety and tolerability of metformin, specifically in patients with prediabetes. The data presented shows evidence that lifestyle modifications are first-line treatment for prediabetes while metformin use should be reserved for those who fail lifestyle modifications or are considered to be high-risk and/or patients that have shown more efficacious results with metformin therapy: BMI ≥ 35 kg/m2, patients less than 60 years old, and women who have a prior history of gestational diabetes mellitus. Decades of research show that metformin is an effective and safe treatment option for patients with prediabetes. However, the combined efficacy of lifestyle modifications and metformin use for prediabetes needs to be further studied to find out why additive benefits are not demonstrated.