Metformin and Gestational Diabetes Mellitus: A Review Article

Background and Objective: Gestational Diabetes Mellitus (GDM) is the main metabolic disorder in pregnancy and has had an increasing prevalence in recent years. Treatment of GDM aims to reduce hyperglycemia and in turn reduce the risk of adverse perinatal outcomes. Although insulin therapy has been known as the main treatment in GDM but disadvantages of insulin for the mother include the need for injections, risk of hypoglycemia, increased appetite and weight gain, highlights the need to use other medications. Metformin is increasingly being used a therapeutic option for the management of GDM. The aim of this review article was study of benefits and complications of metformin in patients with gestational diabetes.Materials and Methods: 28 related articles from 2007 to 2018 were reviewed with the keywords of metformin, gestational diabetes and efficacy in Cochrane Library, PubMed, Google Scholar, SID and Springer Link.Results: 18 review articles, 8 interventional-clinical trials and 2 observational-case control study were reviewed. All papers had considered medical management of gestational diabetes, that according to, Metformin is listed as a FDA category B drug for use during pregnancy, it crosses the placenta and releases in milk pretty low. It is also familiar, relatively inexpensive, easy to administer, and reduces uterine artery impedance between 12-20 weeks. Compared with insulin, metformin has similar efficacy and safety in maternal and infant outcomes and may also have little or no difference in the risk of pre-eclampsia and induction of labor. However, failure rate is likely to be higher in those with an earlier diagnosis of GDM, higher blood glucose, higher body mass index or previous history of GDM and failed to affect maternal lipid parameters and C-reactive protein levels. In addition, women who were given metformin may gain slightly less weight during pregnancy, but are more likely to experience diarrhea.Conclusion: Although metformin is a safe and effective drug to manage blood glucose in patients with mild GDM who prefer to not utilize insulin or who cannot afford insulin therapy, it seems that evidence in short- and long-term clinical outcomes of this drug is insufficient and further RCT researches in this field is recommended

Keywords:

Metformin , Gestational Diabetes , Pregnancy