Efficacy of metformin versus lifestyle modifications in preventing type 2 diabetes mellitus: a meta-analysis of randomized controlled trials

Authors

  • Salman A. Alotifi Department of Family Medicine, Armed Forces Hospital, Southern Region, Saudi Arabia
  • Fatimah A. D. Alshehri Department of Family Medicine, Armed Forces Hospital, Southern Region, Saudi Arabia
  • Salman Q. Y. Mashyakhi Department of Family Medicine, Armed Forces Hospital, Southern Region, Saudi Arabia
  • Mohammed S. F. Alyahya Department of Family Medicine, Armed Forces Hospital, Southern Region, Saudi Arabia
  • Abdulrahman A. S. Alqahtani Department of Family Medicine, Armed Forces Hospital, Southern Region, Saudi Arabia
  • Mohammed R. A. Asiri Department of Family Medicine, Ministry of Health, Aseer Health Cluster, Aseer, Saudi Arabia
  • Saif S. S. Alkhidhran Department of Family Medicine, Armed Forces Hospital, Southern Region, Saudi Arabia

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20250011

Keywords:

Metformin, Lifestyle modifications, Type 2 diabetes mellitus, T2DM prevention, Randomized controlled trials, Meta-analysis

Abstract

Type 2 diabetes mellitus (T2DM) poses a growing global health burden. Prevention strategies typically focus on lifestyle modifications or pharmacological interventions, such as metformin, but their comparative efficacy remains unclear. This study aims to evaluate and compare the efficacy of metformin versus lifestyle modifications in reducing the incidence of T2DM among high-risk individuals. A comprehensive meta-analysis of randomized controlled trials (RCTs) was conducted. Systematic searches of PubMed, Embase, and Cochrane databases were performed. Eight RCTs involving 4,684 participants (2,324 in the metformin group and 2,360 in the lifestyle modification group) were included. The primary outcome was the incidence of T2DM, measured as odds ratio (OR) with corresponding 95% confidence intervals (CI). Heterogeneity was assessed using I² statistics. The pooled analysis demonstrated no significant difference in the incidence of T2DM between metformin and lifestyle modification groups (OR: 1.03, 95% CI: 0.64 to 1.65). Substantial heterogeneity was observed (I²=78%, p<0.0001). In conclusion, metformin and lifestyle modifications are similarly effective in preventing T2DM among high-risk individuals. These findings support the use of both interventions, with lifestyle modifications preferred for broader health benefits and metformin as a viable alternative for individuals unable to sustain lifestyle changes. Future studies should explore factors contributing to heterogeneity and assess long-term outcomes.

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Published

2025-01-09

How to Cite

Alotifi, S. A., Alshehri, F. A. D., Mashyakhi, S. Q. Y., Alyahya, M. S. F., Alqahtani, A. A. S., Asiri, M. R. A., & Alkhidhran, S. S. S. (2025). Efficacy of metformin versus lifestyle modifications in preventing type 2 diabetes mellitus: a meta-analysis of randomized controlled trials. International Journal Of Community Medicine And Public Health, 12(2), 906–912. https://doi.org/10.18203/2394-6040.ijcmph20250011

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Section

Meta-Analysis