Assessment of Metformin Versus Insulin for the Treatment of Gestational Diabetes

Abstract
Background: Metformin is a logical treatment for women with gestational diabetes, but randomized trials to assess the efficacy and safety of its use for this condition are lacking.
Aim of Study: To compare the efficacy of oral metformin therapy versus insulin treatment in patients with gestational diabetes mellitus in term of Maternal glycemic control, Ma-ternal outcome and Fetal outcome.
Patients and Method: A total of 156 patients who have the diagnosis of gestationl diabetes were enrolled after fulfilling certain inclusion and exclusion criteria. They were randomly assigned to two groups of treatment with either insulin or metformin. Serial ultra-sound examination and blood glucose level were assessed at enrolment and at follow-up visits. The outcomes were fetal and maternal outcomes.
Results: Of the 78 patients at each group 89.7% of patients using metformin were compliant to its use while only 39.7% who received insulin therapy were compliant to it (p-value 0.015), neonatal hypoglycemia was associated more with insulin group than metformin group (7.7% vs. 0.0%, p-value 0.028). The rates of other outcomes did not differ significantly between the groups. There were no serious adverse events associated with the use of metformin.
Conclusion: Oral metformin therapy is an effective and safe treatment option for women with gestational diabetes who meet the criteria for starting insulin, and that metformin is more acceptable than insulin. But further follow-up data are needed to establish long-term safety regarding the preg-nancy outcome.