The PRuDENTE initiative, sponsored by the Instituto Nacional de Salud Publica in Mexico, aims to evaluate the cost-effectiveness of metformin combined with lifestyle modifications in preventing type 2 diabetes among pre-diabetic adults with obesity. Given the high prevalence of diabetes in Mexico, this study addresses a significant public health challenge and has the potential to inform national healthcare policies. If successful, the findings could lead to broader adoption of metformin as a preventive measure, impacting the pharmaceutical market for diabetes medications and lifestyle interventions. The study's outcomes may also attract interest from healthcare providers and insurers focused on cost-effective diabetes prevention strategies.