Current and emerging pharmacotherapy for prediabetes: are we moving forward?

Lifestyle intervention is the cornerstone for preventing progression to diabetes, but metformin remains the first line pharmacological intervention. There appears to be minimal additive effect of combining metformin with lifestyle changes. It would be interesting to assess whether using combination pharmacological approaches plus or minus lifestyle interventions have any additive benefit. Despite the good level of evidence available, the penetrance of any interventions remains very low in part due to the prodromal categorization of the prediabetic state.