Metformin for Preventing Frailty in High-risk Older Adults.

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The purpose of this Research Supplement to Promote Diversity in Health-Related Research is to understand the factors that lead to onset of diabetes and frailty and to determine the temporal relationship between frailty and diabetes incidence in older adults. This research will also support the career development of Tiffany Cortes, MD, an endocrinologist and clinical investigator working with the PI of the parent trial (Espinoza). For this study, we will take advantage of the ongoing clinical trial where we are examining older, non-frail prediabetic patients over two years to test whether increased insulin sensitivity with metformin alters frailty onset. We will also conduct a larger cohort study in order to examine the incidence of diabetes and frailty in older adults using Veterans Administration (VA) clinical/administrative data. Briefly, our specific aims are: (1) Identify factors that increase the risk of conversion from prediabetes to diabetes, and predictors of diabetes and frailty in our prospective clinical trial. (2) Examine factors related to the onset of diabetes and frailty in an older veteran population. By accomplishing these aims, this study will shed light on risk factors for frailty and diabetes onset in older adults and the temporal relationship of these. This data will also provide the foundation for a future larger pragmatic study focused on prevention of frailty in older adults.