The present review arises on the need to know the current position in relation to the optimal treatment of insulin resistance (IR), which is defined as a suboptimal response of this hormone, and prediabetes (preDT2), defined as an alteration of glucose at blood level, known as the previous step to Diabetes Mellitus type 2 (DT2). We specifically compared physical activity with the most widely used and studied drug on the market, Metformin. For this study access to databases of related articles, in order to collect, summarize and present the therapeutic options and the results that have been the different working groups, and thus know the best work strategy and planning for this type of patients. We obtained that change of lifestyles, mainly the performance of physical activity over 150 minutes per week, shows good results, decreasing the transition from preDT2 to DT2, compared to the exclusive use of metformin. Exercise also decreases body weight, which is associated with a decrease in the passage from preDT2 to DT2. On the other hand, it has observed that, by combining both therapies, metformin and exercise, no statistically significant improvements are achieve comparing to exercise alone. In addition, the use of metformin in prediabetics results in a statistically significant reduction in oxygen consumption, maximum heart rate and duration of the exercise.

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