Medication for Prediabetes

Prediabetes is a condition with higher-than-normal blood sugar levels, according to the National Institute of Digestive and Diabetes and Kidney Diseases. You may not feel sick or have any symptoms, but having prediabetes (also known as borderline diabetes) puts you at higher risk for developing type 2 diabetes within a few years. About 5 to 10% of people with prediabetes develop diabetes each year, and 90% of people with prediabetes will develop diabetes within the next 20 years, according to a review article in Diabetes Care.

Prediabetes treatments can lower your risk for diabetes and complications of diabetes. Lifestyle modifications, such as losing extra weight and increasing physical activity, are the most effective approaches for most people.

Certain medications can also help delay the onset of type 2 diabetes or prevent it altogether. Metformin is the most common blood sugar-lowering medication for prediabetes, but there are others. These prescription medications are only for some patients with prediabetes, and they work best when you also adapt a healthy lifestyle.

Prediabetes Treatment Approaches: Lifestyle versus Medication

Prediabetes treatment can have these components.

• Lifestyle modification to make healthy behavior choices in daily life.
• Prediabetes medication(s) to control blood sugar and/or increase insulin sensitivity.
• Screening and any necessary treatment for high blood pressure and high cholesterol.

Lifestyle Modification: The American Diabetes Association (ADA) recommends that people with prediabetes take part in a lifestyle intervention program. This can be a Centers for Disease Control and Prevention (CDC)-Recognized Diabetes Prevention Program (DPP) with a focus on weight loss and physical activity. Eating well and getting enough sleep are examples of other healthy choices that can lower blood sugar. Lark DPP provides coaching, through your smartphone, on all of these areas.

Prediabetes Medication: Medications can help lower blood sugar and reduce type 2 diabetes risk. Metformin is most common, but there are other types of prediabetes medications that are sometimes prescribed. A doctor is more likely to prescribe medication for prediabetes for patients who have a higher body mass index (BMI) or who are younger.

Blood Pressure and Cholesterol Screening: Prediabetes and diabetes are risk factors for high blood pressure and high cholesterol. In turn, those can lead to stroke, kidney disease, and heart disease. A prediabetes treatment plan may include regular blood pressure measurements and blood tests for cholesterol levels. Prescription medications may be necessary to control your numbers.

Most Common Medications for Prediabetes

Classes of medications for patients with prediabetes include biguanides, thiazolidinediones, and α-Glucosidase Inhibitors, according to a review article in World Journal of Diabetes. The best-known biguanide may be metformin, with Glucophage being the most common brand name. Metformin lowers glucose levels in a few ways, as noted in an article published in the journal Drugs.

• Increased insulin sensitivity in your liver to decrease your body's glucose production.
• Increased insulin sensitivity in skeletal muscle, which allows your muscle cells to remove glucose from the bloodstream to lower blood sugar levels.
• Raised rate of anaerobic respiration, which uses glucose, in your gastrointestinal cells.
• Higher amounts of glucagon-like peptide-1 (GLP-1) and beta cell GLP-1 receptors, which helps lower blood glucose.

Metformin also improves cholesterol levels and may help you control your weight. It only appears to aid in a few pounds of weight loss and benefits may only last for a few months to a year, but that is better than most other diabetes medications, which can lead to weight gain.

There are other possible medications for prediabetes. Thiazolidinediones increase insulin sensitivity. They also lower blood glucose by increasing glucose metabolism, but they do this by reducing fat metabolism, and weight gain can occur. Thiazolidinediones raise "good" HDL cholesterol, but there are concerns with heart health because they also raise "bad" LDL cholesterol. Rosiglitazone and pioglitazone are examples of thazolidinediones.

The α-Glucosidase inhibitors are medications that interfere with the digestive process. They inhibit the action of α-Glucosidase, which is an enzyme that breaks down carbohydrates, such as table sugar and starches in foods, into glucose. The result is that less glucose gets into your bloodstream after you eat. Side effects of these medications can include flatulence and diarrhea.

Medication versus Weight Loss and Exercise for Prediabetes

What is better: a pill or a lifestyle change? Can either of them really work, or are you going to get diabetes regardless of what you do? Researchers asked those very questions and set out to answer them in a clinical trial that compared metformin to lifestyle changes to a control group among participants with prediabetes. They made some important discoveries, published in New England Journal of Medicine.

• You can prevent diabetes! Most cases of diabetes are largely preventable if you treat your prediabetes properly.
• Metformin lowered risk of diabetes by 31% compared to the control group.
• Lifestyle changes lowered risk of diabetes by 58% compared to the control group.

This study and similar ones have consistently shown that lifestyle changes, such as losing weight and getting active, are the most effective strategies for lowering blood sugar and preventing diabetes for most people. Most people who are diagnosed with prediabetes are likely to receive a recommendation to make healthier choices before their doctors decide to prescribe medications.

You are more likely to be prescribed metformin for prediabetes if your body mass index (BMI) is over 35, if you had gestational diabetes (diabetes that came during pregnancy and then left), or you are younger than 60 years old. Your doctor may also ask you to consider metformin if lifestyle changes have not worked to bring down your blood sugar levels.

Healthy Lifestyle Changes: Diabetes Prevention Program

The lifestyle intervention in that landmark clinical trial is the basis for what is now the National Diabetes Prevention Program (DPP) led by the Centers for Disease Control and Prevention (CDC). The DPP focuses on hitting weight loss of 5 to 7% of starting weight and achieving 150 minutes per week of physical activity. It is a year-long program that includes 16 lessons in the first 6 months and another 6 lessons in the final 6 months.

There are many DPP providers nation-wide, and many healthcare providers offer them as a benefit. Lark DPP has full recognition from the CDC and is accessible through your smartphone. Lark is always available at your convenience, with no need to travel to in-person meetings or attend sessions on a specific schedule. Lark's program is personalized and designed for weight loss and increased physical activity, but also for healthier eating, better stress management, improved sleep, and continued motivation.

If you have prediabetes, it is worth taking steps to treat it because you can greatly lower your risk for type 2 diabetes. Medications for prediabetes are a strategy that can help, but they are more effective with lifestyle treatments, and may not even be necessary. Talk to your doctor about your options. A DPP such as Lark can help you turn healthy choices into habits that can change your life.

In most cases, it is possible to lower blood sugar or even reverse prediabetes, but it is a lot easier when you have a personal lifestyle coach like Lark in your pocket. Your Lark coach is available 24/7 through your smartphone to offer practical advice and encouragement, and to provide instant feedback when you log meals, exercise, and weight. Lowering blood sugar can feel natural as you earn celebratory badges for good choices and develop healthy habits.

Lark Diabetes Prevention Program is designed to help you lose weight and make other healthy lifestyle choices by taking it one small step at a time. Lark uses established behavior change strategies to help you turn small changes into long-term habits for success. The program is based on a proven program from the Centers for Disease Control and Prevention (CDC) and is backed by experts in nutrition, weight loss, exercise, sleep, and stress management

Millions of Americans have health insurance that covers Lark's Diabetes Prevention Program for eligible members, and you may be one of them! Click or tap here to find out whether you qualify. You may even get a free smart scale and Fitbit as you get started on one of the most exciting and important adventures of your life!