Comparison of Pregnancy Outcome and Glycemic Control between Insulin versus Insulin plus Metformin in Management of Gestational Diabetes

Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance that is first indicated during pregnancy. The aim of this study is the comparison of pregnancy outcome and glycemic control between insulin versus insulin plus metformin in management of gestational diabetes.Materials and methods: In this randomized clinical trial, 60 patients with GDM were enrolled. Patients were divided into 2 groups. In the first group, with 20 patients, if despite insulin proper diet, FBS is still above 100, metformin begins. In the second group with 40 patients, if FBS is high, insulin dose is increased and metformin is not given.Results: Results indicated that differences between two groups of study, was significant in BMI, FBS, APGAR score, BS of infant and total dose of Insulin with P values: 0.03, 0.00, 0.01, 0.009 and 0.00 respectively. Polyhydramnios is greater in Insulin group (25%) versus 11.1%) but the difference is not significant (P value=0.30). In both groups more than 85% of newborns were well without fetal distress. There was no dystocia in both study groups. Based on the frequency of IUFD, the difference between two groups is not significant (P value=0.1). Based on the frequency of Still birth, the difference between two study groups is not significant (P value=0.1)Conclusion: Results showed that prevalence of variables in Iranian pregnant women that treated by insulin or insulin plus metformin is approximately similar. These findings show that adding metformin besides insulin can help better glycemic control.

Keywords:

Gestational diabetes , Metformin , Insulin