Abstract
Metformin is an effective alternative to insulin for nonpregnant women with type 2 diabetes mellitus; however, it has not yet been studied in the setting of gestational diabetes mellitus (GDM). Concerns have been raised about the effect of metformin on fetal development, particularly because it crosses the placenta. In this Practice Point commentary, I discuss the findings of an open-label, multicenter, prospective trial conducted by Rowan et al., in which women with GDM were randomly allocated to receive metformin (plus insulin when necessary) or insulin alone. The rate of a composite neonatal outcome and the efficiency of glycemic control were not significantly different between the groups. Compared with the insulin group, the prevalence of severe neonatal hypoglycemia was lower but the rate of preterm birth was higher in the metformin group. Of note, 46% of metformin-treated women required supplemental insulin. Although the results of this study are encouraging, further data are needed on the long-term safety of metformin before it can be considered as first-line therapy for women with GDM.
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References
Ferrara A et al. (2004) An increase in the incidence of gestational diabetes mellitus: Northern California, 1991–2000. Obstet Gynecol 103: 526–533
Langer O et al. (2000) A comparison of glyburide and insulin in women with gestational diabetes mellitus. NEJM 343: 1134–1138
Khattab S et al. (2006) Metformin reduces abortion in pregnant women with polycystic ovary syndrome. Gynecol Endocrinol 22: 680–684
Rowan JA et al. (2008) Metformin versus insulin for the treatment of gestational diabetes. NEJM 358: 2003–2015
Kahn BF et al. (2006) Predictors of glyburide failure in the treatment of gestational diabetes. Obstet Gyncol 107: 1303–1309
Charles B et al. (2006) Population pharmacokinetics of metformin in late pregnancy. Ther Drug Monit 28: 67–72
Glueck CJ et al. (2004) Height, weight and motor-social development during the first 18 months of life in 126 infants born to 109 mothers with polycystic ovary syndrome who conceived on and continued metformin through pregnancy. Human Reprod 19: 1323–1330
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Feig, D. Metformin therapy for gestational diabetes mellitus: are we there yet?. Nat Rev Endocrinol 4, 654–655 (2008). https://doi.org/10.1038/ncpendmet0969
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DOI: https://doi.org/10.1038/ncpendmet0969
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