Metformin and insulin in the management of gestational diabetes mellitus: preliminary results of a comparison.
OBJECTIVE
To compare glycemic control and neonatal outcomes in women with gestational diabetes mellitus (GDM) treated with metformin vs. insulin.


METHODS
Women with GDM not controlled with diet and exercise were randomized to metformin (n = 32) or insulin (n = 31). The levels of glycemic control as well as maternal/neonatal complications were evaluated.


RESULTS
The mean (+/- SD) fasting and 2-hour postprandial blood glucose did not differ statistically between the 2 treatment groups. No patient failed metformin and required insulin. The majority (27/32) were easily controlled on the initial dosage (500 mg twice a day). Gestational age at entry and delivery (p = 0.077, 0.412) were similar. The difference in the rate of cesarean delivery was not statistically significant between the 2 groups (p = 0.102). Neonatal statistics were also not different between the metformin and insulin groups: birth weight, Apgar score at 5 minutes, respiratory distress syndrome, hyperbilirubinemia, neonatal hypoglycemia and neonatal intensive care unit admission (p = 0.144-0.373).


CONCLUSIONS
Based on these preliminary data, metformin appears to be an effective alternative to insulin in the treatment of GDM.
Moore
Lisa E
LE
Departments of Obstetrics and Gynecology, University of New Mexico, Albuquerque 87131-0001, USA. lemoore@salud.unm.edu
Briery
Christian M
CM
Clokey
Diana
D
Martin
Rick W
RW
Williford
Nancy J
NJ
Bofill
James A
JA
Morrison
John C
JC
D000328:Adult; D019540:Area Under Curve; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism; D016640:Diabetes, Gestational / Q000188:drug therapy*; D005215:Fasting / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin