Metformin is an oral medication that is commonly used in the management of type 2 diabetes. It belongs to the class of medicines known as biguanides and works by reducing glucose production in the liver, improving insulin sensitivity, and increasing glucose uptake by muscle cells. Metformin helps lower blood sugar levels and is often prescribed alongside lifestyle modifications for individuals with type 2 diabetes.

Metformin is a topic of ongoing research and debate in the context of prediabetes. Some studies have shown that Metformin may be beneficial in preventing high blood glucose levels and delaying the progression from prediabetes to diabetes. 

It is believed that Metformin's mechanisms of action, such as reducing insulin resistance and improving glucose metabolism, may contribute to its potential preventive effects.

The American Diabetes Association (ADA) recommends Metformin for individuals with prediabetes who have other risk factors for developing diabetes, such as obesity, a history of diabetes, or high blood pressure. 

However, lifestyle modifications remain the cornerstone of prediabetes management, and Metformin is not universally prescribed for all individuals with prediabetes.

Metformin and Prediabetes

Prediabetes, also known as impaired glucose tolerance, is a condition in which blood sugar levels are higher than usual but not yet high enough to be classified as type 2 diabetes. It is considered a warning sign and an opportunity to take preventive measures to avoid the progression of full-blown diabetes. The 125 mg/dL blood sugar indicates a higher-than-normal glucose concentration in the bloodstream.

Lifestyle modifications, such as regular physical activity, healthy eating, and excess weight management, are typically recommended as the first line of treatment for prediabetes.

If you have prediabetes, it's essential to consult with a doctor who can assess your specific situation and provide personalized recommendations. 

They can help you understand the potential benefits and risks of using Metformin and guide you in making informed decisions regarding your prediabetes management plan.

Do I need Metformin for Prediabetes?

A diabetes-friendly diet and regular exercise can help many people with prediabetes control and even reverse it. Preventing the onset of Type 2 diabetes is the primary goal of treatment. 

Additionally, intensive "lifestyle" adjustments can reduce the chance of acquiring Type 2 diabetes by up to 58% for many prediabetic individuals, but not all.

Whether or not to treat prediabetes with Metformin should be made with a healthcare professional. 

They can evaluate your circumstances, medical history, and lifestyle and provide personalized recommendations.

Metformin can help improve insulin sensitivity, reduce insulin resistance, and lower blood sugar levels. It may also have potential benefits in preventing or delaying the onset of type 2 diabetes. 

Sometimes, a healthcare professional may consider prescribing Metformin for individuals with prediabetes who have additional risk factors for developing diabetes. These factors may include obesity, a history of diabetes, or other metabolic conditions.

Is Taking Metformin for Prediabetes Safe?

Metformin is generally considered safe for treating prediabetes when used as prescribed and under the guidance of a healthcare professional. It is a well-established medication used for many years to manage type 2 diabetes. To help persons with prediabetes delay the onset of type 2 diabetes (T2D), the ADA advised them to use Metformin as a therapeutic option in 2007

Metformin may have potential side effects like any medication, but they are usually mild and temporary. Common side effects include gastrointestinal symptoms such as nausea, diarrhea, and stomach upset. These side effects can often be minimized by starting with a low dose and gradually increasing it over time. These side effects often diminish as the body adjusts to the medication.

Serious side effects from Metformin are rare but can occur in certain circumstances. These may include lactic acidosis, a rare but potentially severe condition characterized by the buildup of lactic acid in the blood. However, the risk of lactic acidosis with Metformin is extremely low, especially when used appropriately in individuals with normal kidney function. It's important to note that the risk of lactic acidosis is much higher in individuals with significant kidney or liver impairment.

Before starting Metformin, your healthcare professional will assess your medical history, including any conditions or medications that may increase the risk of complications.

What Are the Pros of Taking Metformin for Prediabetes?

The use of Metformin for prediabetes is a topic of ongoing research and discussion. Metformin offers several advantages when used for prediabetes. Firstly, it can help delay or prevent the onset of type 2 diabetes. Studies have demonstrated that Metformin can effectively reduce the risk of developing diabetes in individuals with prediabetes, particularly those with a significant risk factor, like a family history of diabetes. Metformin helps regulate blood sugar levels and maintains them within a healthy range by improving insulin sensitivity and reducing insulin resistance.

Secondly, Metformin supports weight management efforts. It is either weight-neutral or may even lead to modest weight loss. Metformin's weight-reducing effect can contribute to improved insulin sensitivity and metabolic function.

Additionally, Metformin has been associated with cardiovascular benefits. Individuals with prediabetes are at an increased risk of developing cardiovascular disease. Metformin has been shown to lower the risk of cardiovascular events, such as heart attacks and strokes, in this population. Its mechanisms of action, including reducing insulin resistance and inflammation, may contribute to these positive effects.

Furthermore, Metformin is generally safe and well-tolerated. Side effects, such as gastrointestinal symptoms, are usually mild and transient. The risk of severe side effects is low when used appropriately in individuals with normal kidney function.

What Are the Cons of Taking Metformin for Diabetes?

Metformin is generally safe and well-tolerated for the treatment of prediabetes. However, some potential cons or side effects need to be considered. Gastrointestinal symptoms such as nausea, diarrhea, and stomach upset are common with Metformin use but are typically mild and temporary. Vitamin B12 deficiency may occur with long-term use, requiring regular monitoring and potential supplementation. 

Lactic acidosis, a rare but serious condition, can occur in individuals with impaired kidney or liver function, though the risk is extremely low for those with normal kidney function. Regular kidney function monitoring is necessary to ensure its safe use. Metformin may also interact with certain medications, and these potential interactions should be discussed with a healthcare professional. They can guide the appropriate use of Metformin and monitor for any possible side effects. 

Can Metformin Reverse Prediabetes?

Metformin can help delay or prevent the progression from prediabetes to type 2 diabetes, but it is not considered a medication that can completely reverse prediabetes. Lifestyle modifications remain essential for managing and potentially reversing prediabetes.

Frequently Asked Questions

Will I be on Metformin forever?

The need for long-term Metformin use depends on individual circumstances and should be determined by a healthcare professional.

What is the best medication for prediabetes?

Medication is typically not advised for those with prediabetes until lifestyle adjustments aren't lowering blood sugar levels. Doctors prescribe Metformin if the prescription is required.

Will Metformin bring down your A1c?

When taken at maximal doses, Metformin significantly reduces A1c values by up to 1.5% while controlling blood glucose. Metformin typically does not result in low blood sugar on its own.


Prediabetes management primarily focuses on lifestyle changes, including diet, exercise, and weight management. Medications such as Metformin may be prescribed in some instances, but the decision should be made by a healthcare professional considering individual factors and medical guidance.


At Diabetic Me, we are committed to delivering information that is precise, accurate, and pertinent. Our articles are supported by verified data from research papers, prestigious organizations, academic institutions, and medical associations to guarantee the integrity and relevance of the information we provide. You can learn more about our process and team on the about us page.

  1. National Library of Medicine Metformin and Type 2 Diabetes Prevention
  2. National Library of Medicine Metformin: Current knowledge
  3. American Diabetes Association Prevention or Delay of Type 2 Diabetes: Standards of Medical Care in Diabetes—2019

About the Author

Ely Fornoville

Hi, I'm Ely Fornoville, and I am the founder of Diabetic Me. Being a type 1 diabetic since 1996, I developed a passion to help people learn more about diabetes. I write about diabetes and share stories from other diabetics around the world. I currently use a Medtronic Guardian 4 CGM and a MiniMed 780G insulin pump with Humalog insulin.

View All Articles