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VNA of Care New England

Metformin Usually Adequate for Control of Gestational Diabetes

About 26 percent of women initially treated with metformin require supplemental insulin
FRIDAY, Aug. 16 (HealthDay News) -- Among women with gestational diabetes mellitus, those receiving metformin achieve lower mean glucose levels compared with those receiving insulin, but some require supplemental insulin therapy, according to research published in the July issue of the American Journal of Obstetrics & Gynecology.
Cristiane Pavão Spaulonci, M.D., of the University of São Paulo in Brazil, and colleagues randomly assigned women with gestational diabetes who failed to achieve glycemic control with diet and exercise to therapy with either metformin (47 patients) or insulin (47 patients).
The researchers found that mean glucose levels, amount of weight gain, and rate of neonatal hypoglycemia were all significantly lower in women receiving metformin compared with those receiving insulin. About 26 percent of the women receiving metformin needed supplemental insulin therapy to achieve glycemic control. Logistic regression analysis showed that earlier gestational age at diagnosis and higher mean pretreatment glucose level increased the probability of need for supplemental insulin.
"We believe that a long-term follow-up is needed, but a discussion by specialist teams on the use of metformin as a first-line drug in the treatment of patients with gestational diabetes would be of great usefulness for patients and doctors," the authors write.
Abstract (http://www.ajog.org/article/S0002-9378(13)00296-2/abstract )Full Text (subscription or payment may be required) (http://www.ajog.org/article/S0002-9378(13)00296-2/fulltext )
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