Metformin compared to insulin for the management of gestational diabetic

Abstract

A prospective comparative two arms study done in Al Kadhimiya teaching hospital for 1 year duration from January 2017 till January 2018, this study included 150 women with singleton pregnancies diagnosed with gestational DM. The primary endpoints were neonatal outcomes which include; neonatal hypoglycemia (≥2 neonatal glucose values 46.8 m/dL), respiratory distress (admission to neonatal care unite NUC), need for phototherapy (neonatal jaundice), 5-minute Apgar scores below 7, or premature birth (<37 weeks of gestation). The maternal outcome includes the rate of gestational hyperten-sion, preeclampsia, mode of delivery and Polyhydramnios. Metformin offer less risk for the neonate to have an episode of blood glucose level <28.8 mg/dl compared to insulin RR (95%CI): 0.598 (0.457 – 0.999) and it was significant, metformin also offer less risk for the neonate to have recurrent blood glucose level <46.8 mg/dl RR (95%CI): 0.820 (0.586 – 1.289) but it was not statisti-cally significant, metformin had slightly increased risk for preterm birth compared to insulin, the rest of the variables did not show a significant difference between both drugs. There was no significant difference in the maternal outcome between both drugs. There was no significant difference between met-formin and insulin in their FPG and HbA1c after commencing therapy. In con-clusion, metformin is an effective and safe treatment option for women with GDM, and that metformin comparable with insulin in glycemic control, there is no a significant risk of maternal or perinatal adverse outcome with the use of metformin compared with insulin in GDM.