Inclusion Criteria:  adult patients (aged 18-80 years) with prediabetes overweight/obesity (BMI ≥25kg/m2) patients who speak English or Spanish  Exclusion Criteria:  type 2 diabetes dementia serum creatinine >1.4mg/dL in women and >1.5mg/dL in men current use of oral corticosteroids current pregnancy uncontrolled hypertension (≥180/100mmHg) history of metformin use no office visits during the last 12 months