Metformin Versus Insulin in the Managment of Gestational Diabetes Mellitus

Authors

  • Nuha Muhsen
  • Sajda Al-Rubai
  • Huda Qahtan

DOI:

https://doi.org/10.37506/ijfmt.v16i3.18297

Keywords:

Metformin; Insulin; Gestational Diabetes.

Abstract

Background: Insulin and metformin have been used extensively in the management of gestational diabetes mellitus (GDM).
Insulin has been the primary medical treatment if maternal glucose targets are not achieved by dietary therapy.
Insulin is safe for the fetus, because it does not normally cross the placenta. oral antidiabetic agents, glibenclamide
and metformin are the most studied agents to treat GDM patients.
Objective: To examine If oral metformln Is as effective as Insulin ln the prevention of fetal macrosomy ln
pregnancies complicated with gestational diabetes mellitus.
Method: This study is an open -labeled prospective randomized controlled study that was carried out in Basra
maternity-outpatient clinics in the tertiary level hospital ln Basra. One hundred women with GDM who did
not attain euglycaemia with diet participated. Women were randomized to therapy with insulin n= 50 or oral
metformin n=50. Incidence of macrosomia in infants and neonatal morbidity was measured.
Results: There were no statistically significant differences tn the incidence of macrosomia (16°/o versus 20°/o)
, and neonatal morbidity between insulin and metformtn group. Around 15 (30°/o) of the metformin treated
women needed supplemental insulin. They were more obese,(36.2 versus 30.6) kg/m2 bad higher fasting blood
glucose level (7.4mmol/L versus 6.1 mmol/L) and needed medical treatment for GDM earlier ( 27 versus 32 wks )
than women who were normoglycemic with metformin alone. There was a tendency to a higher rate of caesarean
sections in the metformin group than in the insulin group.
Conclusion: Metformin seems to be suitable for the prevention of fetal macrosomia , especially in lean or moderately
overweight women developing GDM in late pregnancy Women with considerable obesity, high fasting blood
glucose and an early need for pharmacological treatment may be more suitable for insulin therapy.

Author Biographies

Nuha Muhsen

Doctor, MBChB, Basra Hospital for Maternity and Children, Basrah, Iraq.

Sajda Al-Rubai

Professor, FICOG, Basra Hospital for Maternity and Children, Basrah, Iraq.

Huda Qahtan

Professor, FICOG, Basra Hospital for Maternity and Children, Basrah, Iraq.

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Published

2022-07-04

How to Cite

Nuha Muhsen, Sajda Al-Rubai, & Huda Qahtan. (2022). Metformin Versus Insulin in the Managment of Gestational Diabetes Mellitus. Indian Journal of Forensic Medicine & Toxicology, 16(3), 275–279. https://doi.org/10.37506/ijfmt.v16i3.18297