A Comparative Study of the HbA ₁ c Level in Prediabetic Patients With Lifestyle Modification Versus Oral Hypoglycemic Agents

Background: Lifestyle modifications are the cornerstone of prediabetes management, aiming to prevent or delay progression to diabetes. In addition to lifestyle interventions, pharmacologic treatment with oral hypoglycemic agents (OHAs), particularly metformin, is frequently considered. Objectives: The objective of this study was to identify optimal strategies for the management of prediabetes in low‐ and middle‐income countries (LMICs) like Nepal. Methods: A comparative experimental study was conducted to assess the effects of lifestyle modification and treatment with OHA separately in prediabetic patients (16 per group). The lifestyle modification group (Group A) received structured counseling on dietary modifications and physical activity, and the OHA group (Group B) was prescribed metformin. Baseline parameters were recorded for all participants, and blood pressure and HbA1c levels were reassessed at 90 days to determine changes from the baseline. Results: Significant reduction in HbA1c was observed for both the OHA group ( p = 0.0034) and the lifestyle modification group ( p < 0.001). The lifestyle modification group achieved significantly greater reductions in HbA1c compared with the OHA group ( p = 0.0002). Conclusions: Lifestyle modification and pharmacological therapy with metformin can lead to a significant decrease in HbA1c levels in the prediabetic population as a sole intervention. Lifestyle modification resulting in greater reduction could be a sustainable and cost‐effective alternative, particularly in LMICs like Nepal.