Diabetes Q&A

Metformin Could Prevent Diabetes in HIV Patients

Treatment with metformin improves insulin resistance and could prevent diabetes mellitus in HIV-infected individuals with prediabetes, according to the results of a recent study.


Prediabetes is often observed in patients with HIV who are receiving antiretroviral therapy (ART). Because metformin has been shown to reduce the risk of progression to diabetes in patients with prediabetes without HIV, researchers speculated that the same benefits could be seen in patients with HIV.


They conducted an open-label randomized controlled clinical trial involving 74 patients with HIV and prediabetes. The participants were randomized into 2 groups, either receiving metformin or not receiving metformin (control).


The participants were counseled on lifestyle modification and followed for 6 months. At baseline, mean CD4 cell count was 570 cells/mm3 and mean body mass index (BMI) was 24.6 kg/m2.


At 6 months, a single patient in the metformin group and 2 in the control group developed diabetes (risk reduction 2.70%). The mean hemoglobin A1c level was significantly decreased from baseline in the metformin group, as was mean insulin resistance.


“Metformin appears to improve insulin resistance and prevent progression to [diabetes] in HIV-infected patients with [prediabetes]. Further study with longer study period is needed to evaluate long-term benefit of metformin.”


—Michael Potts




Jiriyasin S, Nimitphong H, Sungkanuparph S. Metformin for preventing diabetes mellitus in HIV-infected patients with prediabetes: a randomized controlled trial. Presented at: IDWeek 2018; October 3-7, 2018; San Francisco, CA. https://idsa.confex.com/idsa/2018/webprogram/Paper72561.html. Accessed October 25, 2018.