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On the other hand data from the Diabetes Prevention Program study of 3234 pre-diabetic subjects over an average of 2.8 years who were randomized to receive placebo, metformin (850 mg bid), or lifestyle intervention, indicated that although both metformin and lifestyle changes were effective in reducing the risk of developing diabetes, lifestyle intervention was more effective ( Since both exercise and metformin can improve glycemic control and since both mediate their effects via the activation of AMPK, this suggests that there should be at least an additive effect when metformin use is combined with exercise

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Nausea, appetite changes, or mild stomach discomfort can occur while the body adjusts