A Vaccination Pill for Diabetes Prevention in 65 Countries

In this Prediabates episode 4, joining us in today's discussion is Dr Mala Dharmalingam, Director and Head of Endocrinology at the Bangalore Endocrinology and Diabetes Center, Bengaluru, India and Dr Pramila Kalra, professor and Head of Department of Endocrinology, M S Ramaiah Medical College and Memorial hospital, Bengaluru, India. This episode will focus on Metformin in Prediabetes: A Vaccination Pill for Diabetes Prevention in 65 Countries. India sits on a sugary iceberg—prediabetes now affects more people than type 2 diabetes. While lifestyle change remains the cornerstone of prevention, there is growing global recognition of the role of pharmacological support. Metformin is already approved for prediabetes in over 65 countries, including by the DCGI in India in 2022. With a long-standing track record of efficacy, safety, affordability, and ease of use, metformin is emerging as a practical option in diabetes prevention. They answer the following questions: 1) Why is Prediabetes not as benign or complacent a diagnosis as the term indicates, especially in the Indian context? 2) Are Lifestyle Interventions alone enough in Prediabetes? 3) Why Metformin in Prediabetes? 4) When would you use metformin in prediabetes – a DCGI-approved pharmacological agent in your clinical practice? 5) What are the potential benefits of using metformin early in Prediabetes? 6) What is the protocol you follow in clinical practice while recommending metformin in prediabetes? 7) What dose of metformin do you recommend to initiate in prediabetes? 8) In the current prediabetes landscape of India, how important is metformin in the larger picture of diabetes prevention