title: Metformin Use in Prediabetes Among U.S. Adults, 2005-2012.
abstract: To determine the prevalence of and characteristics associated with metformin use among U.S. adults with prediabetes using the National Health and Nutrition Examination Survey (NHANES) 2005-2012.
  
  
  
  The American Diabetes Association's guidelines for metformin use in prediabetes have evolved, with 2017 recommendations suggesting metformin be considered in patients with prediabetes and additional risk factors (BMI ≥35 kg/m2, age <60 years, or prior gestational diabetes mellitus) or rising hemoglobin A1c(HbA1c). We estimated the age-adjusted prevalence of metformin use among individuals with prediabetes (defined by HbA1c5.7-6.4%, fasting glucose 100-125 mg/dL, 2-h poststimulated glucose 140-199 mg/dL, or self-report) and used multivariate logistic regression to evaluate characteristics associated with metformin use.
  
  
  
  Of 22,174 adults, 7,652 had prediabetes. The age-adjusted prevalence of metformin use among those with prediabetes was 0.7%. Metformin use was associated with higher mean BMI (35.1 kg/m2vs. 29.6 kg/m2,P< 0.01) and higher glucose (fasting glucose 114 mg/dL vs. 105 mg/dL,P= 0.03; 2-h poststimulated glucose 155 mg/dL vs. 128 mg/dL,P= 0.003; and HbA1c6.0% [42 mmol/mmol] vs. 5.6% [38 mmol/mmol],P< 0.01). Metformin use was low even among those with BMI ≥35 kg/m2, a group for whom metformin use is recommended. Metformin use did not vary by race, poverty-to-income ratio, or education.
  
  
  
  Metformin use was <1% among U.S. adults with prediabetes and only slightly more common among those with additional risk factors for diabetes.
authors.affiliation: Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD etseng3@jhmi.edu.
authors.forename: Eva
authors.identifier: 0000-0003-4001-2869
authors.initials: E
authors.lastname: Tseng
authors.affiliation: Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD.|Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.|Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD.
authors.forename: Hsin-Chieh
authors.initials: HC
authors.lastname: Yeh
authors.affiliation: Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD.|Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.|Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD.
authors.forename: Nisa M
authors.initials: NM
authors.lastname: Maruthur
mesh_terms: D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D008687:Metformin / Q000008:administration & dosage*; D008875:Middle Aged; D009749:Nutrition Surveys; D011236:Prediabetic State / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008687:Metformin; C517652:hemoglobin A1c protein, human