Are there any medications for prediabetes?

William Lee Dubois
Endocrinology Diabetes & Metabolism
Yes. No. Kinda.
OK, here’s the deal, the FDA hasn’t actually approved any medications for prediabetes, but doctors commonly prescribe two classes of medications “off label” to help treat the condition.
The first class are thiazolidinediones, conveniently called TZDs, such as Actos. These are basically anti-insulin resistance medications. As prediabetes is a growing problem of insulin resistance, a medication to fight insulin resistance is a logical fit to try and prevent what we call conversion—that is moving from prediabetes to full-blown diabetes. The thought is that by reducing insulin resistance you can reduce overwork on the part of the pancreas (which is working overtime to try and overwhelm the insulin resistance) and thus delay the “burnout” of the pancreas that causes diabetes.
The other class of drugs that seem to help are biguanides, such as Metformin. Met has a small effect on insulin resistance but for the most part attacks another part of the prediabetes equation which is the liver’s tendency to over produce hormones that raise the blood sugar level.
There is also one other prescription for prediabetes that isn’t really a medication at all, but it works very well, and that is to lose some weight. Most people with prediabetes are overweight (you know who you are), and the more you weigh the more resistant your body is to the insulin you make, which means you need to make more, and so on.
Hold on, hold on. Don’t stop reading yet! I can feel you tuning me out! I didn’t say you have to get skinny and svelte. Every little bit of weight you lose can lower your insulin resistance.
Another way of thinking about that is that each pound you drop pushes diabetes further into the future. And that’s a prescription worth filling.

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