Since 2008, the American Diabetes Association has recommended metformin as an adjunct to intensive lifestyle intervention for people with prediabetes, especially those with BMI ≥35 kg/m2, with history of gestational diabetes mellitus (hxGDM), or aged <60 years (1). Prior studies assessing trends of metformin use among patients with prediabetes yielded mixed results and were limited by small sample size, use of self-reported information, insufficient control for important patient characteristics, and lack of recent data (2,3). In this study, we used a claims-based data set to examine metformin use among >900,000 people with prediabetes from 2008 to 2020.
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