Metformin vs insulin in the management of gestational diabetes: a systematic review and meta-analysis.
OBJECTIVE
To evaluate the effectiveness of metformin compared with insulin in achieving glycemic control and investigate the maternal and neonatal outcomes in gestational diabetes mellitus.


METHODS
We searched four electronic databases from inception through December 2012. Terms for Gestational diabetes/gestational diabetes mellitus/diabetes pregnancy AND/OR Metformin/hypoglycemic drugs/Hypoglycemic Agents/Antidiabetic Medications were used in the search. Two investigators independently reviewed titles and abstracts, performed data abstraction on full articles, and assessed study quality. Meanwhile, manual search of other resources and the search on Google Scholar were also carried out to identify more related articles .Rev Man 5.0 was used to analyze the data.


RESULTS
Six randomized clinical trials involving 1420 subjects were included. The current limited data suggested that using metformin in gestational diabetes subjects did not significantly increase adverse maternal outcomes and neonatal outcomes, also with less weight gain and neonatal hypoglycemia, but a higher incidence of premature birth.


CONCLUSIONS
Metformin will not increase the incidence of adverse maternal outcomes and neonatal outcomes.
2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, The Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, 300070 Tianjin, China. Electronic address: 940886709@qq.com.
D F
DF
Su
2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, The Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, 300070 Tianjin, China.
X Y
XY
Wang
D016640:Diabetes, Gestational / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*; D011247:Pregnancy; D011379:Prognosis
D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin
Gestational diabetes; Insulin; Meta-analysis; Metformin; Pregnancy complications; Systematic review