Prediabetes guide

Prediabetes and starting metformin online in Virginia and West Virginia

This guide is for a documented prediabetes lab result in someone not yet diagnosed with diabetes, not for an A1c of 6.5% or higher or a scheduled contrast-dye imaging study.

Start online

Start a $59 online review for Prediabetes (metformin).

Review for adults with a documented prediabetes lab result (A1c 5.7 to 6.4%, fasting glucose 100 to 125, or an abnormal oral glucose tolerance test) who want to discuss starting metformin alongside lifestyle change, per USPSTF and ADA guidance. Upload your lab result; the physician reviews contraindications and, when appropriate, composes a metformin starting dose by hand.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visit See response windows

Quick facts

You must be physically located in Virginia or West Virginia at the time of request.
Starts at $59
No insurance needed
No app download
Physician review around the clock
Non-controlled prescriptions can be sent to your pharmacy when appropriate
A work or school note can be included when medically appropriate
Response windows: 24/7, every day

Common symptoms

An A1c between 5.7% and 6.4% on routine bloodwork
A fasting glucose between 100 and 125 mg/dL
No prior diagnosis of diabetes

May fit online care

Adults 18 and older
A documented prediabetes lab result you can upload
No known liver disease or heavy regular alcohol use
eGFR at or above 45
Not scheduled for contrast-dye imaging in the next 2 days

Look for another care setting

Unusual muscle pain, weakness, and trouble breathing after starting metformin
Persistent vomiting or inability to keep food or fluids down after starting metformin
New extreme thirst, frequent urination, or unexplained weight loss
An A1c of 6.5% or higher, or a fasting glucose of 126 or higher (this is diabetes, not prediabetes)

What to have ready

Your lab result showing the prediabetes range (upload it)
Any known liver or kidney disease
Your alcohol use
Any upcoming imaging study with contrast dye

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer the fit questions, and choose the response window you want. If the concern still fits this service, a physician reviews it and sends a secure update after sign-in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD — board-certified, cardiology-fellowship-trained, and Alpha Omega Alpha. Licensed in Virginia and West Virginia — your care is never handed off.

Verify Virginia medical license Verify West Virginia medical license Verify board certification

What if my A1c is 6.5% or higher?

That is in the diabetes range, not prediabetes, and belongs with our Type 2 diabetes options rather than this lane.

See the Type 2 diabetes options

Is metformin required, or just an option?

It's a discussion, not a requirement. Lifestyle change is the foundation for prediabetes; metformin is one option the physician considers alongside it, based on USPSTF and ADA guidance and your individual risk factors.

I'm having a CT scan with contrast soon — does that matter?

Yes — metformin is often held around contrast-dye imaging, so mention any scheduled scan before starting.

Related conditions we treat

Not quite what you have? These are the closest concerns this service covers.

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