title: Maternal and neonatal circulating markers of metabolic and cardiovascular risk in the metformin in gestational diabetes (MiG) trial: responses to maternal metformin versus insulin treatment.
abstract: OBJECTIVE
  This study was designed to compare glucose, lipids, and C-reactive protein (CRP) in women with gestational diabetes mellitus treated with metformin or insulin and in cord plasma of their offspring and to examine how these markers relate to infant size at birth.
  
  
  METHODS
  Women with gestational diabetes mellitus were randomly assigned to metformin or insulin in the Metformin in Gestational Diabetes trial. Fasting maternal plasma glucose, lipids, and CRP were measured at randomization, 36 weeks' gestation, and 6-8 weeks postpartum as well as in cord plasma. Women with available cord blood samples (metformin n = 236, insulin n = 242) were included.
  
  
  RESULTS
  Maternal plasma triglycerides increased more from randomization to 36 weeks' gestation in women treated with metformin (21.93%) versus insulin (9.69%, P < 0.001). Maternal and cord plasma lipids, CRP, and neonatal anthropometry did not differ between treatments. In logistic regression analyses adjusted for confounders, the strongest associations with birth weight >90th centile were maternal triglycerides and measures of glucose control at 36 weeks.
  
  
  CONCLUSIONS
  There were few differences in circulating maternal and neonatal markers of metabolic status and no differences in measures of anthropometry between the offspring of women treated with metformin and the offspring of women treated with insulin. There may be subtle effects of metformin on maternal lipid function, but the findings suggest that treating gestational diabetes mellitus with metformin does not adversely affect lipids or CRP in cord plasma or neonatal anthropometric measures.
authors.affiliation: UQ Centre for Clinical Research, University of Queensland, Herston, Queensland, Australia. h.barrett@uq.edu.au
authors.forename: Helen L
authors.initials: HL
authors.lastname: Barrett
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Gatford
authors.forename: Candice M
authors.initials: CM
authors.lastname: Houda
authors.forename: Miles J
authors.initials: MJ
authors.lastname: De Blasio
authors.forename: H David
authors.initials: HD
authors.lastname: McIntyre
authors.forename: Leonie K
authors.initials: LK
authors.lastname: Callaway
authors.forename: Marloes
authors.initials: M
authors.lastname: Dekker Nitert
authors.forename: Suzette
authors.initials: S
authors.lastname: Coat
authors.forename: Julie A
authors.initials: JA
authors.lastname: Owens
authors.forename: William M
authors.initials: WM
authors.lastname: Hague
authors.forename: Janet A
authors.initials: JA
authors.lastname: Rowan
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D016640:Diabetes, Gestational / Q000097:blood* / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use*; D020738:Leptin / Q000097:blood; D008687:Metformin / Q000627:therapeutic use*; D011247:Pregnancy; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D002097:C-Reactive Protein; D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D020738:Leptin; D008687:Metformin; D014280:Triglycerides