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Trends in Self-reported Prediabetes and Metformin Use in the USA: NHANES 2005–2014

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Abstract

Background

The American Diabetes Association (ADA) recommends that treatment with metformin be considered for prevention of type 2 diabetes in persons with prediabetes. However, metformin use outside the setting of diagnosed diabetes in US adults is not well characterized.

Objective

To examine trends in self-reported prediabetes and treatment with metformin. We also compared characteristics of adults self-reported prediabetes who were vs. were not taking metformin.

Design

Cross-sectional analysis.

Participants

Adults ≥ 20 years of age who participated in the 2005–2014 National Health and Nutrition and Examination Survey (NHANES), n = 28,461.

Approach

We characterized trends in self-reported prediabetes and metformin use in this population. We used multiple logistic regression models to identify predictors of metformin use among adults with self-reported prediabetes. All analyses accounted for the weighted complex survey design to generate nationally representative estimates.

Key Results

The prevalence of self-reported prediabetes increased from 5.1% in 2005–2006 to 7.4% in 2013–2014 (P-for-trend < 0.001). In persons with self-reported prediabetes, metformin use increased, from 2.4 to 8.3% (P-for-trend = 0.013). Adults who were taking metformin were more likely to be obese and to report trying to lose weight in the past year.

Conclusions

Self-reported prediabetes has increased in the past decade. Metformin use in the setting of prediabetes has also increased but remains relatively uncommon at 8% in adults who self-report prediabetes, despite current clinical recommendations.

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Acknowledgments

The authors would like to thank NHANES staff and participants.

Funding Information

Elizabeth Selvin was supported by NIH/NIDDK grant K24 DK106414. Kathryn Foti was supported by NIH/NHLBI grant T32 HL007024.

Author information

Correspondence to Elizabeth Selvin PhD, MPH.

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The authors have no conflicts of interests to disclose.

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Liu, C., Foti, K., Grams, M.E. et al. Trends in Self-reported Prediabetes and Metformin Use in the USA: NHANES 2005–2014. J GEN INTERN MED 35, 95–101 (2020) doi:10.1007/s11606-019-05398-5

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KEY WORDS

  • diabetes
  • epidemiology
  • guidelines
  • prevention
  • population health