ResearchObstetricsRandomized trial of metformin vs insulin in the management of gestational diabetes
Section snippets
Materials and Methods
Ninety-two women diagnosed with GDM, who received prenatal care at the Obstetrics Clinic of Hospital das Clinicas, Sao Paulo University School of Medicine (HC-FMUSP), Sao Paulo, Brazil, were studied prospectively between Nov. 1, 2007, and Jan 31, 2010. Criteria for inclusion were singleton pregnancy, use of diet and exercise for a minimum period of 1 week without satisfactory glycemic control, absence of risk factors for lactic acidosis (renal failure, heart failure, chronic liver disease,
Results
The initial sample consisted of 94 women who were randomized into the metformin group (group 1, n = 47) or the insulin group (group 2, n = 47). Two women were excluded for discontinuing prenatal care (1 from each group). This gave a final sample of 92 women (46 in the metformin group and 46 in the insulin group) (Figure 1).16 One of the women who presented metformin intolerance wished to discontinue the medication and human NPH was therefore introduced. For the purposes of data analysis, this
Comment
The primary objective of this study was to evaluate glycemic control in women with GDM treated with metformin or insulin. After introduction of the drugs, lower mean glucose levels were observed in the group receiving metformin (P = .020), especially after dinner (P = .042). These findings demonstrate that metformin is an effective agent for achieving glycemic control in women with GDM. In addition, weight gain between diagnosis of GDM and delivery (P = .002) and between beginning of treatment
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Metformin for gestational diabetes study: metformin vs insulin in gestational diabetes: glycemic control and obstetrical and perinatal outcomes: randomized prospective trial
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Clinical trial registration: Umin Clinical Trials Registry, http://www.umin.ac.jp/ctr/index.htm. UMIN 000005393.
The authors report no conflict of interest.
Cite this article as: Spaulonci CP, Bernardes LS, Trindade TC, et al. Randomized trial of metformin vs insulin in the management of gestational diabetes. Am J Obstet Gynecol 2013;209:34.e1-7.