Metformin prescription for U.S. veterans with prediabetes, 2010-2019.
J Investig Med
; 72(1): 139-150, 2024 01.
Article
en En
| MEDLINE
| ID: mdl-37668313
ABSTRACT
Affecting an estimated 88 million Americans, prediabetes increases the risk for developing type 2 diabetes mellitus (T2DM), and independently, cardiovascular disease, retinopathy, nephropathy, and neuropathy. Nevertheless, little is known about the use of metformin for diabetes prevention among patients in the Veterans Health Administration, the largest integrated healthcare system in the U.S. This is a retrospective observational cohort study of the proportion of Veterans with incident prediabetes who were prescribed metformin at the Veterans Health Administration from October 2010 to September 2019. Among 1,059,605 Veterans with incident prediabetes, 12,009 (1.1%) were prescribed metformin during an average 3.4 years of observation after diagnosis. Metformin prescribing was marginally higher (1.6%) among those with body mass index (BMI) ≥35 kg/m2, age <60 years, HbA1c≥6.0%, or those with a history of gestational diabetes, all subgroups at a higher risk for progression to T2DM. In a multivariable model, metformin was more likely to be prescribed for those with BMI ≥35 kg/m2 incidence rate ratio [IRR] 2.6 [95% confidence intervals (CI) 2.1-3.3], female sex IRR, 2.4 [95% CI 1.8-3.3], HbA1c≥6% IRR, 1.93 [95% CI 1.5-2.4], age <60 years IRR, 1.7 [95% CI 1.3-2.3], hypertriglyceridemia IRR, 1.5 [95% CI 1.2-1.9], hypertension IRR, 1.5 [95% CI 1.1-2.1], Major Depressive Disorder IRR, 1.5 [95% CI 1.1-2.0], or schizophrenia IRR, 2.1 [95% CI 1.2-3.8]. Over 20% of Veterans with prediabetes attended a comprehensive structured lifestyle modification clinic or program. Among Veterans with prediabetes, metformin was prescribed to 1.1% overall, a proportion that marginally increased to 1.6% in the subset of individuals at highest risk for progression to T2DM.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Estado Prediabético
/
Veteranos
/
Trastorno Depresivo Mayor
/
Diabetes Mellitus Tipo 2
/
Metformina
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
J Investig Med
Asunto de la revista:
MEDICINA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos