title: Metformin treatment in type 2 diabetes in pregnancy: an active controlled, parallel-group, randomized, open label study in patients with type 2 diabetes in pregnancy.
abstract: OBJECTIVE
  To assess the effect of metformin and to compare it with insulin treatment in patients with type 2 diabetes in pregnancy in terms of perinatal outcome, maternal complications, additional insulin requirement, and treatment acceptability.
  
  
  METHODS
  In this randomized, open label study, 206 patients with type 2 diabetes in pregnancy who met the eligibility criteria were selected from the antenatal clinics. Insulin was added to metformin treatment when required, to maintain the target glycemic control. The patients were followed up till delivery. Maternal, and perinatal outcomes and pharmacotherapeutic characteristics were recorded on a proforma.
  
  
  RESULTS
  Maternal characteristics were comparable in metformin and insulin treated group. 84.9% patients in metformin group required add-on insulin therapy at mean gestational age of 26.58 ± 3.85 weeks. Less maternal weight gain (P < 0.001) and pregnancy induced hypertension (P = 0.029) were observed in metformin treated group. Small for date babies were more in metformin group (P < 0.01). Neonatal hypoglycemia was significantly less and so was NICU stay of >24 hours in metformin group (P < 0.01). Significant reduction in cost of treatment was found in metformin group.
  
  
  CONCLUSIONS
  Metformin alone or with add-on insulin is an effective and cheap treatment option for patients with type 2 diabetes in pregnancy. This trial is registered with clinical trial registration number: Clinical trials.gov NCT01855763.
authors: Department of Obstetrics and Gynecology, Dow University of Health Sciences, Karachi 74400, Pakistan.
authors: Jahan Ara
authors: JA
authors: Ainuddin
authors: Department of Pharmacology, Medical and Dental College, Bahria University, Karachi 75500, Pakistan.
authors: Nasim
authors: N
authors: Karim
authors: School of Public Health, Dow University of Health Sciences, Karachi 75300, Pakistan.
authors: Sidra
authors: S
authors: Zaheer
authors: Department of Community Health Sciences, United Medical and Dental College, Karachi 74900, Pakistan.
authors: Syed Sanwer
authors: SS
authors: Ali
authors: Department of Obstetrics and Gynecology, Hamdard University Hospital, Karachi 74400, Pakistan.
authors: Anjum Ara
authors: AA
authors: Hasan
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000187:drug effects; D048909:Diabetes Complications / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008687:Metformin / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011256:Pregnancy Outcome; D016896:Treatment Outcome; D015430:Weight Gain
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin