A Comparison of Metformin and Insulin for Gestational Diabetes Treatment
What is the best treatment option for pregnant women with diabetes? Is metformin safer than insulin? A team led by researchers in the Division of Maternal Fetal Medicine at the University of North Carolina, Chapel Hill set out to explore these questions.
Their study, “Metformin compared with insulin in the treatment of pregnant women with overt diabetes: a randomi zed controlled trial,” appears in the American Journal of Perinatology. It was published online ahead of print in October 2012.
The researchers were interested in the safety of, and complications associated with, both metformin and insulin when used to help with glycemic control in women with type 2 diabetes, and women with early A2 gestational diabetes.
Twenty-eight women were included in the study (14 women with preexisting type 2 diabetes, and 14 with early gestational diabetes). Early gestational diabetes was defined as women with the condition who needed medical care prior to their 20th week. The women were all randomly assigned to 2 conditions: metformin or insulin treatment.
The study outcomes included women’s tolerance of the treatments, neonatal complications, obstetric complications, weight gain, women’s satisfaction with their therapy, and neonatal cord blood C-peptide. The participants’ glycemic control was measured and compared between the groups.
All of the women who were in the metformin group continued to receive the medication until they gave birth; however, almost half (43%) needed insulin to help with glycemic control. The results of the study showed that glucose measures were not significantly different between women taking metformin and those in the insulin group. Additionally, women in the metformin group had fewer hypoglycemic episodes than the women in the insulin condition.
The study authors argue that their findings support the use of metformin in the treatment of type 2 diabetes in women, and women with early A2 gestational diabetes.