The facts: Metformin vs Lifestyle interventions on Diabetes.

In 2002 the New England Journal of Medicine published a study (Volume 346 number 6) that took people with impaired glucose intolerance (this is the step before being diagnosed with diabetes) and divided them into three groups.  One group was given "normal care" which consisted of Metformin (popular glucose controlling agent) and the second group was not given any drugs but was instructed to exercise and change their eating habits.  The third group was given a placebo.  The subjects were followed for 4 years and at the end of that time were assessed as to who progressed to full fleg diabetes.  It was found that the Metformin group when compared to the placebo group had 1/3 fewer incidents of diabetes!  This is great and was lauded as such, I quote  

“In 2002, researchers showed that metformin reduced by 1/3 the number of those with prediabetes—people with impaired glucose tolerance—that progressed to diabetes during a 3 yr period…. Thanks to the curiosity, ingenuity, and determination of scientists from various fields, we now have powerful new weapons to combat an old debilitating disease.”

Patlak M. Combating Diabetes. FASEB J 16:1853, 2002

There is one problem here, the group that was not mentioned i.e. the group not given any drugs but that was instructed to eat right and exercise reduced there incidence of diabetes by 1/2!  As the scientific community praises the then new wonder drug, those who didn't take it but changed their lifestyle were far better off.

One final note, the lifestyle intervention group only lost about 5 pounds over the course of the 4 years, thus signifying that pounds lost is not as important as being physically active.