Gestational diabetes: treatment with metformin compared to insulin

点击翻译按钮获取中文摘要

Gestational diabetes (GDM) is diagnosed when women have elevated blood sugar levels detected in pregnancy. Treatment aims to keep the mother's blood sugar normal and to prevent extra sugar transferring to the baby, as this can lead to elevated insulin levels, and subsequent complications, in the baby. Initial treatment is by diet, but more than 30% of women need further treatment with insulin injections. Metformin, which can be taken by as a tablet, is an alternative to insulin that is used widely outside pregnancy for people with diabetes. There are good data to support the safety of metformin in pregnancy. We plan to test that metformin is not only safe but also an effective alternative to insulin for women with GDM. Metformin works by reducing resistance to insulin, which is a key factor for the development of GDM and also for high blood pressure complications. We hope to demonstrate a reduction in these complications with metformin treatment. Metformin is associated with less weight gain than insulin and we hope to demonstrate an associated reduction in the risk of diabetes following pregnancy in women with GDM treated with metformin. It is likely that metformin crosses the placenta, and if so, it may reduce elevated insulin levels in the baby. The study will measure insulin levels in the cord blood, hoping to demonstrate that more babies have normal insulin levels in pregnancies treated with metformin.