PMID- 37668313
OWN - NLM
STAT- MEDLINE
DCOM- 20231220
LR  - 20231220
IS  - 1708-8267 (Electronic)
IS  - 1081-5589 (Linking)
VI  - 72
IP  - 1
DP  - 2024 Jan
TI  - Metformin prescription for U.S. veterans with prediabetes, 2010-2019.
PG  - 139-150
LID - 10.1177/10815589231201141 [doi]
AB  - 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/m(2), age <60 years, 
      HbA(1c)>/=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/m(2) 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], HbA(1c)>/=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.
FAU - Gulanski, Barbara I
AU  - Gulanski BI
AD  - Department of Medicine, Endocrinology, VA Connecticut Healthcare System, West 
      Haven, CT, USA.
AD  - Department of Medicine, Endocrinology, Yale University School of Medicine, New 
      Haven, CT, USA.
FAU - Goulet, Joseph L
AU  - Goulet JL
AD  - Section of Biomedical Informatics and Data Science, Yale University School of 
      Medicine, New Haven, CT, USA.
AD  - Pain, Research, Informatics, Multi-morbidities and Education Center (PRIME), West 
      Haven, CT, USA.
FAU - Radhakrishnan, Krishnan
AU  - Radhakrishnan K
AD  - National Mental Health and Substance Use Policy Laboratory, Substance Abuse and 
      Mental Health Services Administration, Rockville, MD, USA.
FAU - Ko, John
AU  - Ko J
AD  - VA Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), 
      VA Connecticut Healthcare System, West Haven, CT, USA.
FAU - Li, Yuli
AU  - Li Y
AD  - Section of Biomedical Informatics and Data Science, Yale University School of 
      Medicine, New Haven, CT, USA.
AD  - VA Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), 
      VA Connecticut Healthcare System, West Haven, CT, USA.
FAU - Rajeevan, Nallakkandi
AU  - Rajeevan N
AD  - Section of Biomedical Informatics and Data Science, Yale University School of 
      Medicine, New Haven, CT, USA.
AD  - VA Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), 
      VA Connecticut Healthcare System, West Haven, CT, USA.
FAU - Lee, Kyung Min
AU  - Lee KM
AD  - VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care 
      System, Salt Lake City, UT, USA.
FAU - Heberer, Kent
AU  - Heberer K
AD  - VA Palo Alto Cooperative Studies Program Coordinating Center, VA Palo Alto Heath 
      Care System, CA, USA.
AD  - Division of Endocrinology, Gerontology, and Metabolism, Department of Medicine, 
      Endocrinology, Stanford University School of Medicine, Stanford, CA, USA.
FAU - Lynch, Julie A
AU  - Lynch JA
AD  - VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care 
      System, Salt Lake City, UT, USA.
AD  - Department of Internal Medicine, Division of Epidemiology, University of Utah 
      School of Medicine, Salt Lake City, UT, USA.
FAU - Streja, Elani
AU  - Streja E
AD  - Department of Medicine, Nephrology, Hypertension and Transplant, University of 
      California-Irvine School of Medicine, Long Beach, CA, USA.
FAU - Mutalik, Pradeep
AU  - Mutalik P
AD  - Section of Biomedical Informatics and Data Science, Yale University School of 
      Medicine, New Haven, CT, USA.
AD  - VA Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), 
      VA Connecticut Healthcare System, West Haven, CT, USA.
FAU - Cheung, Kei-Hoi
AU  - Cheung KH
AD  - Section of Biomedical Informatics and Data Science, Yale University School of 
      Medicine, New Haven, CT, USA.
AD  - VA Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), 
      VA Connecticut Healthcare System, West Haven, CT, USA.
AD  - Department of Emergency Medicine, Yale University School of Medicine, New Haven, 
      CT, USA.
FAU - Concato, John
AU  - Concato J
AD  - Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.
AD  - Center for Drug Evaluation and Research, Food and Drug Administration, Silver 
      Spring, MD, USA.
FAU - Shih, Mei-Chiung
AU  - Shih MC
AD  - VA Palo Alto Cooperative Studies Program Coordinating Center, VA Palo Alto Heath 
      Care System, CA, USA.
AD  - Department of Biomedical Data Science, Stanford University School of Medicine, 
      Stanford, CA, USA.
FAU - Lee, Jennifer S
AU  - Lee JS
AD  - VA Palo Alto Cooperative Studies Program Coordinating Center, VA Palo Alto Heath 
      Care System, CA, USA.
AD  - Division of Endocrinology, Gerontology, and Metabolism, Department of Medicine, 
      Endocrinology, Stanford University School of Medicine, Stanford, CA, USA.
FAU - Aslan, Mihaela
AU  - Aslan M
AD  - VA Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), 
      VA Connecticut Healthcare System, West Haven, CT, USA.
AD  - Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20231120
PL  - England
TA  - J Investig Med
JT  - Journal of investigative medicine : the official publication of the American 
      Federation for Clinical Research
JID - 9501229
RN  - 0 (Hypoglycemic Agents)
RN  - 9100L32L2N (Metformin)
SB  - IM
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Cohort Studies
MH  - *Depressive Disorder, Major/drug therapy
MH  - *Diabetes Mellitus, Type 2/drug therapy/epidemiology/diagnosis
MH  - Hypoglycemic Agents/therapeutic use
MH  - *Metformin/therapeutic use
MH  - *Prediabetic State/drug therapy/epidemiology
MH  - Prescriptions
MH  - *Veterans
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Veterans
OT  - diabetes mellitus
COIS- Declaration of conflicting interestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2023/09/05 12:42
MHDA- 2023/12/17 09:45
CRDT- 2023/09/05 08:23
PHST- 2023/12/17 09:45 [medline]
PHST- 2023/09/05 12:42 [pubmed]
PHST- 2023/09/05 08:23 [entrez]
AID - 10.1177/10815589231201141 [doi]
PST - ppublish
SO  - J Investig Med. 2024 Jan;72(1):139-150. doi: 10.1177/10815589231201141. Epub 2023 
      Nov 20.