American Board of Family Medicine (ABFM) Practice Exam

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Which medication is considered effective for preventing the development of diabetes in patients with pre-diabetes?

Metformin
Insulin
Sulfonylureas
GLP-1 receptor agonists

The correct answer is: Metformin

Metformin is recognized as an effective medication for preventing the onset of diabetes in individuals diagnosed with pre-diabetes. This is primarily due to its ability to improve insulin sensitivity, which helps reduce blood glucose levels and regulate the body's response to insulin. Clinical studies have demonstrated that metformin not only aids in blood sugar control but also significantly decreases the risk of progressing from pre-diabetes to type 2 diabetes by approximately 30% to 40% when compared to placebo. The other options, while used in diabetes management, do not serve the same preventative purpose in pre-diabetes cases. Insulin is mainly utilized for those who already have diabetes and struggle to maintain adequate glucose control. Sulfonylureas are also primarily designed to lower blood sugar in established diabetes and do not offer preventive benefits in those with pre-diabetes. GLP-1 receptor agonists can promote weight loss and improve glycemic control but are typically indicated for diabetes management rather than prevention in pre-diabetic individuals. Therefore, metformin stands out as the optimal choice in the context of pre-diabetes prevention.