title: Metformin in gestational diabetes: the offspring follow-up (MiG TOFU): body composition at 2 years of age.
abstract: OBJECTIVE
  In women with gestational diabetes mellitus, who were randomized to metformin or insulin treatment, pregnancy outcomes were similar (Metformin in Gestational diabetes [MiG] trial). Metformin crosses the placenta, so it is important to assess potential effects on growth of the children.
  
  
  METHODS
  In Auckland, New Zealand, and Adelaide, Australia, women who had participated in the MiG trial were reviewed when their children were 2 years old. Body composition was measured in 154 and 164 children whose mothers had been randomized to metformin and insulin, respectively. Children were assessed with anthropometry, bioimpedance, and dual energy X-ray absorptiometry (DEXA), using standard methods.
  
  
  RESULTS
  The children were similar for baseline maternal characteristics and pregnancy outcomes. In the metformin group, compared with the insulin group, children had larger mid-upper arm circumferences (17.2 ± 1.5 vs. 16.7 ± 1.5 cm; P = 0.002) and subscapular (6.3 ± 1.9 vs. 6.0 ± 1.7 mm; P = 0.02) and biceps skinfolds (6.03 ± 1.9 vs. 5.6 ± 1.7 mm; P = 0.04). Total fat mass and percentage body fat assessed by bioimpedance (n = 221) and DEXA (n = 114) were not different.
  
  
  CONCLUSIONS
  Children exposed to metformin had larger measures of subcutaneous fat, but overall body fat was the same as in children whose mothers were treated with insulin alone. Further follow-up is required to examine whether these findings persist into later life and whether children exposed to metformin will develop less visceral fat and be more insulin sensitive. If so, this would have significant implications for the current pandemic of diabetes.
authors.affiliation: Department of Obstetrics, National Women’s Health, Auckland, New Zealand. janetrowan1@gmail.com
authors.forename: Janet A
authors.initials: JA
authors.lastname: Rowan
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Rush
authors.forename: Victor
authors.initials: V
authors.lastname: Obolonkin
authors.forename: Malcolm
authors.initials: M
authors.lastname: Battin
authors.forename: Trecia
authors.initials: T
authors.lastname: Wouldes
authors.forename: William M
authors.initials: WM
authors.lastname: Hague
mesh_terms: D015502:Absorptiometry, Photon; D000886:Anthropometry; D001823:Body Composition / Q000502:physiology*; D002675:Child, Preschool; D016640:Diabetes, Gestational / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin