Lifestyle intervention (i.e., weight loss, exercise, healthy eating, reduction or cessation of alcohol intake) is the cornerstone of prediabetes treatment, but metformin is considered the first-line pharmacological intervention. It’s recommended that metformin be added for people with prediabetes who have a BMI of at least 35, higher glucose levels (e.g., fasting glucose ≥ 110 mg/dL, HbA1c ≥ 6.0%), and/or a history of gestational diabetes.[1] Metformin may also be considered in cases where lifestyle intervention is ineffective.[2] Weight-loss drugs (e.g., semaglutide) are another increasingly popular option to enhance the efficacy of lifestyle intervention.[3][4]