Comparative Effects of Exercise and Metformin on Glycemic Control in Prediabetic Adults

Inclusion Criteria: * Adults aged 18 to 59 years * Diagnosed with prediabetes based on ADA criteria (FPG: 100-125 mg/dL or HbA1c: 5.7-6.4%) * Stable HbA1c levels (no significant fluctuation in the last 3 months) * Body Mass Index (BMI) less than 30 kg/m² * Willing and able to provide written informed consent * Willing to participate in the assigned intervention (exercise or metformin) for 12 weeks * Residing within the community and able to attend scheduled follow-ups Exclusion Criteria: * Age 60 years or older * Diagnosis of Type 2 Diabetes Mellitus (T2DM) or use of anti-diabetic medications * Family history of diabetes in first-degree relatives (parent or sibling) * Known cardiovascular, renal, or hepatic disease * Pregnancy or lactation * Physical disability or limitation that would interfere with performing moderate-intensity exercise * Uncontrolled hypertension (SBP ≥ 160 mmHg or DBP ≥ 100 mmHg) * Known allergy or contraindication to metformin * Alcohol or substance abuse