Medication

Medication can help make lifestyle changes more effective at lowering blood sugar and supporting weight loss.

Your care team may prescribe you medications in addition to lifestyle changes to help you lower your blood sugar, support weight loss, and reduce your risk of developing diabetes. Medication is meant to work alongside healthy eating, movement, sleep, and stress management, not replace them.

How these medications work

Metformin

Metformin is the recommended medication for prediabetes. It works by reducing how much sugar your liver releases into your bloodstream and by helping your body respond better to insulin. This allows sugar to move into your cells, where it can be used for energy instead of building up in your blood.

Metformin is the recommended medication offered because it has the most evidence and because it is safe, effective, and affordable.

GLP-1 Medications

Weight loss can help prevent type 2 diabetes. GLP-1 medications for people without type 2 diabetes support weight loss as well as help control your blood sugar. (Examples include Wegovy®, Saxenda®, and Zepbound®.)

They work by copying a natural hormone in your body that helps release insulin when your blood sugar is high. They also slow how quickly food leaves your stomach, which helps you feel full sooner and longer. Many people find that these medications help reduce hunger and make portion sizes feel more manageable.

These medications work best when combined with healthy eating, regular movement, and other lifestyle changes.

How medication improves your metabolic health

Medication can help make lifestyle changes more effective at lowering blood sugar and supporting weight loss. They work alongside lifestyle changes to give your body extra support while you build habits that protect your long-term metabolic health.

Insurance and cost

Metformin: Very low cost and widely covered by almost all insurance plans.

GLP-1 Medications: Can be very expensive and often not covered for prediabetes or weight loss without other health conditions.

Pros

Metformin:

Effective way to lower blood sugar.
Safe, inexpensive, and available as a generic.
Easy once- or twice-daily pill.

GLP-1 Medications:

Effective at supporting weight loss.
Can help protect your heart and kidneys from long-term damage as well as lowering blood sugar.
Options include a daily or weekly injection or a daily pill.

Cons

Metformin:

Can cause stomach upset or diarrhea (often improves over time). Often started on a lower dose to minimize side effects.

GLP-1 Medications:

Commonly causes nausea or diarrhea early in treatment.
Benefits like weight loss and diabetes prevention stop if you discontinue the medication.
Can be very expensive and often not covered by insurance for prediabetes at this time.
Injections may not be a good option for people who are afraid of needles.

Next steps

Discuss medication options with your care team and let them know if you are using any supplements.

Call your insurance plan to ask about coverage and costs (especially for GLP-1 medications).

If prescribed medication, ask what side effects to expect and how to manage them.

Supplements

Some supplements have good evidence for small benefits in blood sugar control, but they are not a replacement for medication or lifestyle changes. There are other supplements that may claim to help with blood sugar control or weight loss but have no proven effect. Always tell your care team if you are taking supplements.

Sugar cubes stacked alongside glycemic baseline measurement representations

Berberine

Berberine is a plant-based supplement that can help lower blood sugar, A1C, and insulin resistance. Short studies show that berberine can lower your A1C by 0.75% to 1.0%. It may also help improve cholesterol and triglyceride levels.

Because berberine can interact with common medications like metformin and statins, and may lower blood sugar on its own, it is important to talk with your care team before starting it.

Chromium

Chromium has been shown to lower fasting blood sugar, A1C, and insulin resistance in some studies. The benefits may be greater in certain populations, and the ideal dose can vary from person to person.

Because chromium can interact with diabetes medications and may affect the liver or kidneys at high doses, you should check with your care team before starting it.

Psyllium Husk

Psyllium is a soluble fiber that can lower blood sugar and A1C when taken before meals, with the biggest benefits seen in people whose blood sugar is most elevated. It can also help reduce triglycerides and LDL cholesterol, and help with feelings of satiety.

This is one of the few supplements recognized in clinical guidelines for its metabolic benefits.

Cinnamon

Cinnamon supplements may modestly lower fasting blood sugar and A1C, especially at doses of 1–6 grams or more per day in capsule form. A recent study using continuous glucose monitors showed that cinnamon helped reduce blood sugar spikes throughout the day.

The evidence is promising but not yet strong enough for major guidelines to recommend routine use.

Zinc

Zinc supplementation can improve fasting blood sugar, after-meal blood sugar, A1C, and insulin resistance. It may also help with cholesterol, blood pressure, and inflammation. One study found that 20 mg of zinc daily helped slow the progression from prediabetes to diabetes.

Doses up to 40 mg per day are generally considered safe for adults, but long-term use above that amount can lead to copper deficiency.

Disclaimer: Peptides

Non-prescription products marketed as “peptides” for weight loss or diabetes prevention are unproven and largely unregulated.

Peptides sold online or through wellness clinics have not been adequately studied for safety, effectiveness, or long-term health effects.