Objective :- To assess pregnancy outcomes in women with Gestational diabetes treated with Metformin compared to women treated with insulin only.
Methodology :- Retrospective audit comparing maternal and perinatal outcomes in women with gestational diabetes at Gold Coast University hospital in 2003 and 2004 who were managed with diet and Insulin , with those treated in 2013 where management included diet, Metformin and Insulin.
Discussion :- Gestational diabetes is a common pregnancy complication that is increasing in incidence associated with an increased prevalence of T2DM, Obesity and advancing Maternal age. Australian guidelines did not recommend oral hypoglycaemics in the treatment of Gestational diabetes, however Metformin is known to improve insulin resistance, reduce insulin requirement and has been used effectively and safely as initial pharmacological management in women with gestational diabetes. The Metformin in gestational diabetes [MiG] trial found that treatment with Metformin had similar perinatal outcomes as compared to insulin and that it was more acceptable to women with Gestational diabetes. A recent report showed that compared to metformin, insulin is associated with increased weight gain and neonatal hypoglycaemia.
There is a widely recognized need for more data regarding outcomes in pregnancy for women managed with Metformin. This audit comparing pregnancy outcomes of 220 women at our institution who achieved glycaemic control with and without Metformin will contribute towards evidence for the use of Metformin in pregnancy.