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Wednesday, December 11, 2013
IMPAIRED GLUCOSE TOLERANCE and metformin
Sir, I am male/51 years and hypertnsive. Recently, I had check up and my Glucose tolerance test which stated IMPAIRED GLUCOSE TOLERANCE. My internist suggested to take Metformin 250 mg. Is this really needed or am I diabetic I am obese Taking Tenormin 100 Indapamide 1.5 Losartan 100 Amlodepine 10 mg Normal lipids No thyroid No cardiac problems Rest of the parameters normal. Request you Sir to guide me.
One of the main pieces of evidence supporting your doctor in this decision was the type 2 diabetes prevention program (see reference below). According to this study, people who were at risk for developing type 2 diabetes as defined by having impaired glucose tolerance had the rate of proceeding to type 2 diabetes reduced by treatment with metformin. The thinking behind this approach was that slowing the progression to type 2 diabetes should slow the rate of development of the complications of diabetes. So there is a good scientific rationale for this recommendation. Some doctors use this approach and some do not - everything in medicine is a really a judgement, not "written in stone" for all.
Reference: The Diabetes Prevention Program Research Group: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393-403, 2002
Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati