There is a growing population that treats insulin resistant states, especially such as PCOS, with sensitizers like Metformin
. But studies have shown that lifestyle changes are better than metformin
at preventing diabetes, so it is far preferred especially as the first intervention.
Unless there is a contraindication( for example pregnancy, allergy, worsening renal failure on ACEs) , all diabetics with proteinuria should be on an ACE inhibitor or ARB, even if they only tolerate a low dose.