Are there any medications I can take to help prevent diabetes

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Yes, there are a number of medications that will help to reduce the likelihood of a person developing type 2 diabetes, but not type 1 diabetes. These are shown in Table 2. None are labeled by the Food and Drug Administration for this indication. Our use of them is mainly confined to choosing a drug that will tend to slow progression to type 2 diabetes when the drug is needed for another condition. For example, when a patient at risk for diabetes needs treatment for high blood pressure, one would consider using a drug that has been shown to slow progression to diabetes in

Table 2 Medications That May Help to Prevent Diabetes

Medication

Losartan

Carvedilol

Metformin

Acarbose

Hydroxychoroquine Vitamin D Aspirin

Blood pressure

Blood pressure

Blood pressure

Type 2 diabetes

Type 2 diabetes

Rheumatoid arthritis, malaria

Vitamin supplementation

Pain and inflammation

those at high risk, as opposed to one that might actually accelerate it. Early use of drugs that are approved to treat type 2 diabetes in people at high risk of development of type 2 diabetes (mainly those with prediabetes—for definition see Question 9) has also been shown to prevent or delay the onset of the disease. Examples of this use are also shown in Table 2. Whether this represents prevention of diabetes or pretreatment of diabetes is not conclusively known. To be considered true prevention, the drug needs to modify the course and progression of the underlying factors leading to the disease and not merely lower the blood sugar. This means the rate at which those at risk progress to diabetes should be reduced in a sustained manner. It should be emphasized that one must be very cautious in advocating the use of oral antidiabetic drugs in this manner. The FDA and other authoritative bodies have not evaluated the ratio of risk to benefit sufficiently to recommend their use in prediabetes.

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