Which medications are used to reduce the risk of developing diabetes in people with impaired fasting glucose or impaired glucose tolerance?

Which medications are used to reduce the risk of developing diabetes in people with impaired fasting glucose or impaired glucose tolerance?

• A. Metformin alone
• B. Acarbose alone
• C. Metformin, alpha-glucosidase inhibitors (acarbose), orlistat, or thiazolidinediones (glitazones)
• D. Orlistat alone

Answer: (C)

The key idea is that certain medications have been shown to lower the chance of progressing from prediabetes (impaired fasting glucose or impaired glucose tolerance) to type 2 diabetes. Metformin is one such option; evidence from major prevention trials demonstrates a meaningful reduction in diabetes risk with metformin in high‑risk individuals, especially younger and heavier patients. Alpha‑glucosidase inhibitors like acarbose have also been linked to fewer new cases of diabetes in people with prediabetes by slowing carbohydrate absorption after meals. Weight management plays a role too, and orlistat can contribute to reduced diabetes incidence indirectly through weight loss, which improves insulin sensitivity. Thiazolidinediones, such as pioglitazone or rosiglitazone, have shown substantial prevention effects in prediabetes trials, reducing the progression to diabetes in adults with impaired glucose tolerance. Taken together, these four classes—metformin, acarbose, orlistat, and thiazolidinediones—have demonstrated evidence of preventing or delaying the development of diabetes in prediabetes, which is why the comprehensive option is the best answer.

The key idea is that certain medications have been shown to lower the chance of progressing from prediabetes (impaired fasting glucose or impaired glucose tolerance) to type 2 diabetes. Metformin is one such option; evidence from major prevention trials demonstrates a meaningful reduction in diabetes risk with metformin in high‑risk individuals, especially younger and heavier patients. Alpha‑glucosidase inhibitors like acarbose have also been linked to fewer new cases of diabetes in people with prediabetes by slowing carbohydrate absorption after meals.

Weight management plays a role too, and orlistat can contribute to reduced diabetes incidence indirectly through weight loss, which improves insulin sensitivity. Thiazolidinediones, such as pioglitazone or rosiglitazone, have shown substantial prevention effects in prediabetes trials, reducing the progression to diabetes in adults with impaired glucose tolerance.

Taken together, these four classes—metformin, acarbose, orlistat, and thiazolidinediones—have demonstrated evidence of preventing or delaying the development of diabetes in prediabetes, which is why the comprehensive option is the best answer.