A pre-diabetes case concerning metformin assumption to avoid progression to full disease

Abstract

Pre-diabetes is commonly considered a preliminary form of (full) diabetes, which can be delayed to occur later in life by the prescription of daily administration of metformin in addition to personal training through diet and other glucose-reducing general rules.

The Author found himself in such a situation after an infection during a foreign travel, damaging his pancreatic functions and bringing his glucose level quite above 125 mg/dL. He was immediately prescribed a diet and the administration of a brand of metformin. It was assumed for about 8 years until this brand of metformin became commercially unavailable: his previous publications on this subject matter have shown how glucose level was subsequently maintained in the range below 125 mg/dL without exceptions, according to frequent home tests and also according to an annual professional test.

Recently, the author had to change the kind of metformin due to the lack of the former, but he had evidence of some of the problems that are indicated in the literature as typical of this assumption, namely diarrheal. This fact prompted the author to also check whether, in his case, the assumption of metformin was possibly non-strictly needed.

The present case is reported here with the results of a test period of a ≈5 months without interruption, after a month where alternated weeks with and without assumption were spent for a quick observation of the possible differences in the effects. This kind of case strictly requires the use of the methodology the author has developed to perform the home tests: it consists mainly of an extremely careful and frequent recalibration of the tools used in the home tests, strips and testers. He is assuming to be a valid and necessary precaution for studying these types of cases, developed during his very long professional career in Measurement Science and specifically in Metrology.

The results of the study on this case are expected to allow for a forecast over the longer term without need to get a statistics longer than a few months, highlighting two main issues: when combined with a healthy lifestyle, metformin can help patients maintain a stable blood glucose level, even below 100 mg/dL; additionally, the administration of metformin was not necessarily needed to avoid an increase in blood glucose levels above 125 mg/dL over time.

Not being a medical doctor, the author cannot make a general statement about the lack of need for assumption of metformin. The author also found in his case that assumed metformin immediately brought the glucose level even below 100 mg/dL, which can be considered a non-necessary though safer situation—this was also an occasional case for the previous metformin type. On the other hand, this may also indicate that a correct diet and personal training may be sufficient to prevent pre-diabetes.