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J. Clin. Med. 2018, 7(3), 50; https://doi.org/10.3390/jcm7030050

Outcomes for Women with Gestational Diabetes Treated with Metformin: A Retrospective, Case-Control Study

1
Department of Diabetes, Endocrinology and Metabolism, Level 3, Acute Services Building, Royal North Shore Hospital, St Leonards, Sydney NSW 2065, Australia
2
Northern Clinical School, University of Sydney, Sydney NSW 2065, Australia
3
Kolling Institute of Medical Research, St Leonards, Sydney NSW 2065, Australia
4
NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Sydney NSW 2050, Australia
5
Boden Institute, Charles Perkins Centre, University of Sydney, Camperdown, Sydney NSW 2006, Australia
*
Author to whom correspondence should be addressed.
Received: 10 January 2018 / Revised: 5 March 2018 / Accepted: 8 March 2018 / Published: 9 March 2018
(This article belongs to the Special Issue Therapeutic Strategies for Diabetes in Pregnancy)
View Full-Text   |   Download PDF [489 KB, uploaded 9 March 2018]   |  

Abstract

Metformin is increasingly being used a therapeutic option for the management of gestational diabetes mellitus (GDM). The aim of this study was to compare the maternal characteristics and perinatal outcomes of women with GDM treated with metformin (with or without supplemental insulin) with those receiving other management approaches. A retrospective, case-control study was carried out and 83 women taking metformin were matched 1:1 with women receiving insulin or diet and lifestyle modification alone. Women managed with diet and lifestyle modification had a significantly lower fasting plasma glucose (p < 0.001) and HbA1c (p < 0.01) at diagnosis of GDM. Furthermore, women managed with metformin had a higher early pregnancy body mass index (BMI) compared to those receiving insulin or diet and lifestyle modification (p < 0.001). There was no difference in mode of delivery, birth weight or incidence of large- or small-for-gestational-age neonates between groups. Women receiving glucose lowering therapies had a higher rate of neonatal hypoglycaemia (p < 0.05). The incidence of other adverse perinatal outcomes was similar between groups. Despite their greater BMI, women with metformin-treated GDM did not have an increased risk of adverse perinatal outcomes. Metformin is a useful alternative to insulin in the management of GDM. View Full-Text
Keywords: gestational diabetes; metformin; insulin; glycaemic control; perinatal outcomes gestational diabetes; metformin; insulin; glycaemic control; perinatal outcomes
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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McGrath, R.T.; Glastras, S.J.; Scott, E.S.; Hocking, S.L.; Fulcher, G.R. Outcomes for Women with Gestational Diabetes Treated with Metformin: A Retrospective, Case-Control Study. J. Clin. Med. 2018, 7, 50.

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