Zeitschrift für klinische Toxikologie
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Meta-Analysis of the Impact of Lifestyle Intervention Combined with Metformin on the Incidence of New-Onset Diabetes in Prediabetic Asian Populations

Jing Li, Yuchen Ma, Jingyi Lu, Wenxuan Wang, Xin Wang, Yongmei Hao

Introduction: The intervention effect of lifestyle combined with metformin on pre diabetes population in Asia is still unclear. This meta-analysis aims to analyze and evaluate the prevention effect of joint intervention on pre diabetes population in Asia.

Materials and methods: The search strategy was developed according to the PICOS principle, searching in databases such as PubMed, The Cochrane Library, Web of Science, and Embase until October 9, 2023. RCTs in adults with prediabetes, interventions lasting ≥ 1 year. And the outcome indicator was the incidence of diabetes. Relative Risk (RR) was used as the statistical effect size, with interval estimation using a 95% Confidence Interval (CI).

Results: Of 4 studies included in the systematic review, involving 2682 subjects, with 1314 in the experimental group. The results showed that, compared to lifestyle intervention alone, the addition of metformin to lifestyle intervention could further reduce the risk of progression to T2DM by about 17% (95% CI: 7-26, p=0.001) in Asian prediabetes patients.

Conclusions: In Asian prediabetes population, lifestyle intervention combined with metformin can further reduce the risk of diabetes in prediabetes patients compared with lifestyle intervention alone, especially in male patients with abnormal glucose tolerance whose age is less than 45 years old, BMI>25 kg/m², and HbA1c ≤ 5.6%, which can reduce by 17%, and the effect is positively related to the dose of metformin and the intervention time.