Prevention of gestational diabetes by metformin plus diet in patients with polycystic ovary syndrome.
OBJECTIVE
To prospectively assess whether metformin diet safely provides primary and secondary prevention of gestational diabetes (GD).


METHODS
Assess development of GD on metformin diet.


METHODS
Outpatient clinical research center.


METHODS
One hundred forty-two nondiabetic women with polycystic ovary syndrome (PCOS) who had at least one live-birth (LB) pregnancy on metformin diet (172 pregnancies, 180 LBs).


METHODS
Women were given 26% protein, 44% carbohydrate diets, without calorie restriction during pregnancy. Metformin (2-2.55 g/d) was given preconception, through pregnancy.


METHODS
Development of GD.


RESULTS
On metformin, GD developed in 12 (7%) of 172 LB pregnancies. Forty-seven women had at least one previous LB pregnancy (n = 64) without metformin, with GD developing in 19 (30%). Subsequently, on metformin, these 47 women had 50 LB pregnancies, developing GD in 6 (12%), which was a statistically significant difference. Of 15 women who had previous GD without metformin, GD developed in 5 (31%) of 16 subsequent pregnancies on metformin. Of 32 women who were previously free of GD without metformin, GD developed in 1 (3%) of 34 subsequent pregnancies on metformin. Previous GD without metformin was the only statistically significant explanatory variable for current GD on metformin.


CONCLUSIONS
Metformin diet during pregnancy in women with PCOS facilitates primary and secondary prevention of GD.
Glueck
Charles J
CJ
Cholesterol Center, Jewish Hospital, Cincinnati, Ohio 45229, USA. glueckch@healthall.com
Pranikoff
Joel
J
Aregawi
Dawit
D
Wang
Ping
P
D000328:Adult; D001786:Blood Glucose / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D016640:Diabetes, Gestational / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D016015:Logistic Models; D008687:Metformin / Q000009:adverse effects / Q000627:therapeutic use*; D016017:Odds Ratio; D010641:Phenotype; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin