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Licensed Unlicensed Requires Authentication Published by De Gruyter May 3, 2022

Considering metformin as a second-line treatment for children and adolescents with prediabetes

Chelsea M. Hosey ORCID logo, Kelsee Halpin ORCID logo and Yun Yan ORCID logo


Overweight and obesity affect approximately 1/3 of children in the United States and are risk factors for prediabetes and type 2 diabetes. Progression from prediabetes to diabetes carries substantial long-term health burdens, culminating in decreased life-expectancy. Earlier development of type 2 diabetes is associated with poorer prognoses, and children lose glycemic control more rapidly than adults. Metformin is approved by the USFDA for the treatment of type 2 diabetes in children, has limited toxicity, and may help prevent the development of type 2 diabetes. The more rapid disease progression in children and the safety of metformin suggests that initiation of metformin treatment to children with prediabetes who have not effectively responded to lifestyle changes may help prevent short- and long-term health damage resulting from prediabetic and diabetic dysglycemia.

Corresponding author: Yun Yan, MD, Division of Pediatric Endocrinology, Children’s Mercy Hospital, 2401 Gillham Rd, Kansas City, MO 64108, USA, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.


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Received: 2021-03-20
Accepted: 2022-03-30
Published Online: 2022-05-03
Published in Print: 2022-06-27

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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