Are there any medications I can take to help prevent diabetes?

Are there any medications I can take to help prevent diabetes?

Yes, there are a number of medications that will help to reduce the likelihood of a person developing type 2 diabetes, but not type 1 diabetes. These are shown in Table 2. None are labeled by the Food and Drug Administration for this indication. Our use of them is mainly confined to choosing a drug that will tend to slow progression to type 2 diabetes when the drug is needed for another condition. For example, when a patient at risk for diabetes needs treatment for high blood pressure, one would consider using a drug that has been shown to slow progression to diabetes in those at high risk, as opposed to one that might actually accelerate it.

Table 2 Medications That May Help to Prevent Diabetes

Medication	Approved Use
Ramipril	Blood pressure
Losartan	Blood pressure
Carvedilol	Blood pressure
Metformin	Type 2 diabetes
Acarbose	Type 2 diabetes
Hydroxychoroquine	Rheumatoid arthritis, malaria
Vitamin D	Vitamin supplementation
Aspirin	Pain and inflammation

 Early use of drugs that are approved to treat type 2 diabetes in people at high risk of development of type 2 diabetes has also been shown to prevent or delay the onset of the disease. Examples of this use are also shown in Table 2. Whether this represents prevention of diabetes or pretreatment of diabetes is not conclusively known.

To be considered true prevention, the drug needs to modify the course and progression of the underlying factors leading to the disease and not merely lower the blood sugar. This means the rate at which those at risk progress to diabetes should be reduced in a sustained manner. It should be emphasized that one must be very cautious in advocating the use of oral antidiabetic drugs in this manner. The FDA and other authoritative bodies have not evaluated the ratio of risk to benefit sufficiently to recommend their use in prediabetes.