title: Metformin prescription for insured adults with prediabetes from 2010 to 2012: a retrospective cohort study.
abstract: 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.
  
  
  METHODS
  Retrospective cohort analysis over a 3-year period.
  
  
  METHODS
  Employer groups that purchased health plans from the nation's largest private insurer.
  
  
  METHODS
  A national sample of 17 352 working-age adults with prediabetes insured for 3 continuous years between 2010 and 2012.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Missing data on lifestyle interventions, possible misclassification of prediabetes and metformin use, and inability to define eligible patients exactly as defined in the American Diabetes Association guidelines.
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  Centers for Disease Control and Prevention (Division of Diabetes Translation) and the National Institute of Diabetes and Digestive and Kidney Diseases.
authors.forename: Tannaz
authors.initials: T
authors.lastname: Moin
authors.forename: Jinnan
authors.initials: J
authors.lastname: Li
authors.forename: O Kenrik
authors.initials: OK
authors.lastname: Duru
authors.forename: Susan
authors.initials: S
authors.lastname: Ettner
authors.forename: Norman
authors.initials: N
authors.lastname: Turk
authors.forename: Abigail
authors.initials: A
authors.lastname: Keckhafer
authors.forename: Sam
authors.initials: S
authors.lastname: Ho
authors.forename: Carol M
authors.initials: CM
authors.lastname: Mangione
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007348:Insurance, Health; D008019:Life Style; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011236:Prediabetic State / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin