Shelley R. Salpeter, MD: From the Santa Clara Valley Medical Center, San Jose

A recent meta-analysis of 31 randomized controlled trials with 4500 participants showed that metformin treatment significantly decreased weight, improved dyslipidemia and insulin resistance, and reduced the incidence of new-onset diabetes by 40%, with beneficial effects maintained over time. Further studies will show whether the metabolic improvements achieved with metformin treatment will ultimately result in a decrease in cardiovascular morbidity and mortality.