Effect comparison of metformin with insulin treatment for gestational diabetes: a meta-analysis based on RCTs

Abstract

Metformin can significantly reduce several adverse maternal and neonatal outcomes including PIH rate, incidence of hypoglycemia and NICU, thus it may be an effective and safe alternative or additional treatment to insulin for GDM women.

Short‐ and long‐term outcomes of metformin compared with insulin alone in pregnancy: a systematic review and meta‐analysis

“…Women with pregnancy complications (preterm labour, pregnancy-induced hypertension, or pre-eclampsia) were excluded after enrolment. Three systematic reviews have assessed metformin use in women with gestational diabetes mellitus [3,21,22]. In contrast to these publications, we found no increased risk of preterm delivery in women with gestational diabetes mellitus or Type 2 diabetes who were using metformin [3,21].…”

“…Three systematic reviews have assessed metformin use in women with gestational diabetes mellitus . In contrast to these publications, we found no increased risk of preterm delivery in women with gestational diabetes mellitus or Type 2 diabetes who were using metformin .…”

Use of a clinical‐laboratory score to guide treatment of gestational diabetes

“…However, as mentioned previously, we noted that the score group included a greater proportion of women undergoing metformin treatment, as opposed to treatments including diet and/or insulin, compared with the control group. Perinatal studies 23,24 have revealed similar results for metformin and insulin in pregnant women with diabetes. Moreover, the high cost, complexity, storage requirements, and route of administration of insulin increase the attractiveness of metformin as a therapeutic option.…”

“…Silva et al. observed a lower birth weight among pregnant women with diabetes who received metformin compared with those receiving glyburide A meta‐analysis concluded that metformin reduced the incidence of maternal and neonatal adverse effects, including hypoglycemia and NICU admission, compared with insulin. However, additional studies are required to evaluate the potential risks associated with metformin therapy for pregnant women with diabetes …”

Efficacy and safety of metformin for the treatment of gestational diabetes: a new approach to the problem

“…По результатам проведенных РКИ, за последние годы появилось несколько метаанализов [25][26][27][28], подводящих итог сравнению материнских и неонатальных исходов при применении метформина против инсулина (табл. 2).…”