Year: 2009
Type: article
Abstract: OBJECTIVE: To determine the proportion of the American population who would merit metformin treatment, according to recent American Diabetes Association (ADA) consensus panel recommendations to prevent or delay the development of diabetes. RESEARCH DESIGN AND METHODS: Risk factors were evaluated in 1,581 Screening for Impaired Glucose Tolerance (SIGT), 2,014 Third National Health and Nutrition Examination Survey (NHANES III), and 1,111 National Health and Nutrition Examination Survey 2005-2006 (NHANES 2005-2006) subjects, who were non-Hispanic white and black, without known diabetes. Criteria for consideration of metformin included the presence of both impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), with > or =1 additional diabetes risk factor: age <60 years, BMI > or =35 kg/m(2), family history of diabetes, elevated triglycerides, reduced HDL cholesterol, hypertension, or A1C >6.0%. RESULTS: Isolated IFG, isolated IGT, and IFG and IGT were found in 18.0, 7.2, and 8.2% of SIGT; 22.3, 6.4, and 9.4% of NHANES III; and 21.8, 5.0, and 9.0% of NHANES 2005-2006 subjects, respectively. In SIGT, NHANES III, and NHANES 2005-2006, criteria for metformin consideration were met in 99, 96, and 96% of those with IFG and IGT; 31, 29, and 28% of all those with IFG; and 53, 57, and 62% of all those with IGT (8.1, 9.1, and 8.7% of all subjects), respectively. CONCLUSIONS: More than 96% of individuals with both IFG and IGT are likely to meet ADA consensus criteria for consideration of metformin. Because >28% of all those with IFG met the criteria, providers should perform oral glucose tolerance tests to find concomitant IGT in all patients with IFG. To the extent that our findings are representative of the U.S. population, approximately 1 in 12 adults has a combination of pre-diabetes and risk factors that may justify consideration of metformin treatment for diabetes prevention.
Source: Diabetes Care
DOI: 10.2337/dc09-0341
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: American Diabetes Association, Emory University, National Institutes of Health, Agency for Healthcare Research and Quality, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Research Resources, National Center for Advancing Translational Sciences
Awards: G1090428068, G1143685601, Mechanisms Linking Depression to Cardiovascular Risk, G2775279643, G2917670157, G304006002, Emory Mentored Clinical Research Scholar Program, Posttraumatic Stress Disorder and Cardiovascular Disease, Atlanta Clinical and Translational Science Institute (ACTSI) Renewal, Mind-Body Interactions in Cardiovascular Disease, GENERAL CLINICAL RESEARCH CENTER, Screening for IGT: Glucose Challenge vs Predictive Model, CVD Risk and Prevention in Early Glucose Intolerance
OpenAlex ID: W2166540100