Most people with prediabetes get better results by making lifestyle changes, such as losing weight, eating a healthy diet, and getting regular exercise, than with diabetes medicine.⁶

But a doctor may prescribe a biguanide, usually metformin (Glucophage), because it can reduce how much glucose is made by the liver and lower insulin levels, especially in patients with polycystic ovary syndrome. In some cases a doctor may prescribe thiazolidinediones (Actos or Avandia) to lower insulin resistance. One study (the DREAM trial investigation) shows that Avandia prevents type 2 diabetes as effectively as lifestyle change but can cause you to gain weight and/or retain fluid.¹⁸ Metformin is used much more frequently.

Ask your doctor whether diet and exercise are sufficient treatment or whether you should take medicine to lower your insulin resistance.