Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Long-term metformin offsets diabetes in patients with higher glucose/HbA1c, history of gestational diabetes

Key clinical point: Over 15 years, metformin was especially effective in diabetes prevention among persons with higher baseline fasting glucose, higher HbA1c, or a history of gestational diabetes.

Major finding: For women with a history of gestational diabetes, metformin was linked to a 41% reduction in diabetes development, compared with placebo (P = .03).

Study details: A long-term follow-up analysis of individuals in the Diabetes Prevention Program randomized to either metformin or placebo (n = 2,155), of whom about 86% (n = 1,861) continued in the Diabetes Prevention Program Outcomes Study.

Disclosures: The National Institute of Diabetes and Digestive and Kidney Diseases and Department of Veterans Affairs, among others, funded the Diabetes Prevention Program and subsequent outcomes study. Lipha provided medication and LifeScan donated materials during the studies. Additional funding to the Diabetes Prevention Program was provided by Bristol-Myers Squibb and Parke-Davis.


Nathan DM et al. Diabetes Care. 2019 Mar 15. doi: 10.2337/dc18-1970.