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metformin in pregnancy

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https://www.readbyqxmd.com/read/28930827/comparative-efficacy-and-safety-of-oral-antidiabetic-drugs-and-insulin-in-treating-gestational-diabetes-mellitus-an-updated-prisma-compliant-network-meta-analysis
#1
Hui-Ling Liang, Shu-Juan Ma, Yan-Ni Xiao, Hong-Zhuan Tan
BACKGROUND: The safety and efficacy of different drugs in treatment of gestational diabetes mellitus (GDM) patients who could not maintain normal glucose level only through diet and exercise remains to be debated. We performed this network meta-analysis (NAM) to compare and rank different antidiabetic drugs in glucose level control and pregnancy outcomes in GDM patients. METHODS: We searched PubMed, Cochrane Library, Web of Science, and Embase up to December 31, 2016...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28898436/letter-to-liu-et%C3%A2-al-2017-article
#2
Richard S Legro
I was intrigued to see the recent trial of Liu et al(1) reporting the benefits of exenatide over metformin in terms of weight loss and pregnancy rate in women with polycystic ovary syndrome. I am writing to clarify the discrepancies between the trial as registered and the trial as reported in the manuscript. According to the trial registration on the Chinese Clinical Trial Registration Site (ChiCTR-IIR-16008084) the trial was a three armed trial for exenatide, metformin, or spironolactone. This article is protected by copyright...
September 12, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28867510/role-of-metformin-for-ovulation-induction-in-infertile-patients-with-polycystic-ovary-syndrome-pcos-a-guideline
#3
(no author information available yet)
Metformin alone compared with placebo increases the ovulation rate in women with polycystic ovary syndrome (PCOS) but should not be used as first-line therapy for anovulation because oral ovulation induction agents such as clomiphene citrate (CC) or letrozole alone are much more effective in increasing ovulation, pregnancy, and live-birth rates in women with PCOS. There is fair evidence that metformin alone does not increase rates of miscarriage when stopped at the initiation of pregnancy and insufficient evidence that metformin in combination with other agents used to induce ovulation increases live-birth rates...
August 10, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28865539/role-of-metformin-for-ovulation-induction-in-infertile-patients-with-polycystic-ovary-syndrome-pcos-a-guideline
#4
(no author information available yet)
Metformin alone compared with placebo increases the ovulation rate in women with polycystic ovary syndrome (PCOS) but should not be used as first-line therapy for anovulation because oral ovulation induction agents such as clomiphene citrate or letrozole alone are much more effective in increasing ovulation, pregnancy, and live-birth rates in women with PCOS. There is fair evidence that metformin alone does not increase rates of miscarriage when stopped at the initiation of pregnancy and insufficient evidence that metformin in combination with other agents used to induce ovulation increases live-birth rates...
September 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28864965/pharmacological-management-of-gestational-diabetes-mellitus
#5
Geetha Mukerji, Denice S Feig
Gestational diabetes mellitus (GDM) is associated with an increased risk of adverse pregnancy outcomes in the setting of poor glycemic control. The initial management for GDM includes intensive lifestyle modification, which often requires behavioral and nutritional changes to optimize glycemic control. Pharmacotherapy for GDM is initiated when glycemic targets are not met. The rapid-acting bolus analogues aspart and lispro achieve postprandial targets with less hypoglycemia compared to regular insulin, with similar fetal outcomes...
September 2, 2017: Drugs
https://www.readbyqxmd.com/read/28834553/efficacy-of-exenatide-on-weight-loss-metabolic-parameters-and-pregnancy-in-overweight-obese-polycystic-ovary-syndrome
#6
Xin Liu, Ying Zhang, Si-Yuan Zheng, Rong Lin, Yi-Juan Xie, Hui Chen, Yong-Xiong Zheng, En Liu, Lin Chen, Jia-He Yan, Wei Xu, Ting-Ting Mai, Yi Gong
CONTEXT: Weight loss remains one of the most important arms in obese patients with polycystic ovary syndrome (PCOS). Further studies are needed to identify the best treatment. OBJECTIVE: To evaluate the effects of exenatide (EXE) on reproductive and metabolic function in overweight/obese (OW/OB) PCOS. DESIGN: This is a 24-week open-label prospective, randomized, clinical study. PATIENTS AND MEASUREMENTS: This study randomized 176 OW/OB women diagnosed with PCOS to receive either EXE 10 μg BID (n = 88) or metformin (MET) 1000 mg BID (n = 88) for the first 12 weeks...
August 23, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28829492/metformin-increases-norepinephrine-transporter-expression-in-placenta-of-patients-with-polycystic-ovary-syndrome
#7
G Medina, M Maliqueo, N Crisosto, B Echiburú, T Sir-Petermann, H E Lara
OBJECTIVE: To evaluate the norepinephrine (NE) and placental NE transporter (NET) in women with polycystic ovary syndrome (PCOS) non-treated and treated with metformin during pregnancy. PATIENTS AND METHODS: We studied sixteen pregnant women with PCOS: 8 without metformin treatment during pregnancy (PCOS-M) and 8 treated with metformin during pregnancy (PCOS+M). Sixteen pregnant women of similar age without PCOS were included as controls (Control). At 24th and 35th weeks of pregnancy, blood samples were obtained...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28810587/association-of-polycystic-ovary-syndrome-with-metabolic-syndrome-and-gestational-diabetes-aggravated-complication-of-pregnancy
#8
Kui Yao, Ce Bian, Xia Zhao
Polycystic ovary syndrome (PCOS) affects 5-20% of the reproductive age women globally. PCOS is diagnosed by the presence of hyperandrogenism, oligo-anovulation, and polycystic morphology of at least one ovary. Insulin resistance (IR), hyperinsulinemia and associated metabolic abnormalities including metabolic syndrome play a significant role in the development of PCOS. The chances of developing MS in PCOS women was shown to increase by almost 14-fold in patients with increasing body mass index. Even in the absence of overt obesity, a preferential deposition of intra-abdominal fat is noted in PCOS women and this intra-abdominal fat leads to impaired insulin action and functional IR and hyperandrogenism...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28801297/-effect-of-metformin-on-insulin-resistance-during-catch-up-growth-in-mice-with-fetal-growth-restriction
#9
Ping Peng, Chun-Ling Ma, Shu-Mei Wan, Wen-Sheng Jin, Yan Gao, Tian-Qing Huang, Qi Cheng, Chang-Lan Ye
OBJECTIVE: To study the efficacy of metformin intervention on insulin resistance during catch-up growth in mice with fetal growth restriction (FGR). METHODS: Mouse models of FGR were established by low protein diet feeding of the pregnant mice. Both the newborn female mice with FGR and normal control (NC) mice were randomized for feeding with a standard diet (SF) or a high-fat diet (HF) after weaning and treatment with gavage of either metformin or normal saline...
August 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28770325/metformin-use-in-pregnancy-promises-and-uncertainties
#10
REVIEW
Robert S Lindsay, Mary R Loeken
Metformin has been prescribed in pregnancy for over 40 years; for much of this time, use has been limited both in numbers and geographically, and the evidence base has been confined to observational studies. In early years, perceived safety concerns and lack of availability of the drug in many countries acted as a barrier to use. More recently, RCTs have begun to examine the role of metformin in pregnancy in much-needed detail. However, this evidence base has been interpreted differently in different countries, leading to very wide variation in its current application in pregnancy...
August 2, 2017: Diabetologia
https://www.readbyqxmd.com/read/28731890/metformin-exposure-during-pregnancy-and-lactation-did-not-cause-vascular-reactivity-alteration-in-adult-male-offspring
#11
Daniella R B S Novi, Simone Forcato, Camila B Vidigal, Guilherme H Loiola, Daniela C C Gerardin, Graziela S Ceravolo
Metformin has been used for the treatment of some metabolic diseases during gestation and the beneficial effects of metformin to the vascular system have been described in diabetic and obese animal models. Nevertheless, the long term consequences to the vascular system of offspring maternally exposed to metformin have not yet been characterized. Therefore, we want to test the hypothesis that gestational and lactational exposure to metformin would be safe for the vascular reactivity of male adult offspring. Wistar female rats were treated with metformin 293mg/kg/day, by gavage, from gestational day (GD) 0 to GD 21 (METG) or GD 0 until post natal day (PND) 21 (METGL)...
July 19, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28727687/hippocampus-dependent-memory-and-allele-specific-gene-expression-in-adult-offspring-of-alcohol-consuming-dams-after-neonatal-treatment-with-thyroxin-or-metformin
#12
E Tunc-Ozcan, S L Wert, P H Lim, A Ferreira, E E Redei
Fetal alcohol spectrum disorder (FASD), the result of fetal alcohol exposure (FAE), affects 2-11% of children worldwide, with no effective treatments. Hippocampus-based learning and memory deficits are key symptoms of FASD. Our previous studies show hypothyroxinemia and hyperglycemia of the alcohol-consuming pregnant rat, which likely affects fetal neurodevelopment. We administered vehicle, thyroxine (T4) or metformin to neonatal rats post FAE and rats were tested in the hippocampus-dependent contextual fear-conditioning paradigm in adulthood...
July 20, 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28724173/a-comparative-study-between-myo-inositol-and-metformin-in-the-treatment-of-insulin-resistant-women
#13
K Nas, L Tűű
OBJECTIVE: Insulin resistance (IR) is a common disorder, which can impair female fertility and is characterized by phenotypic heterogeneity. Life-style treatment and insulin sensitizers are commonly used in the management of women with IR and consequent hyperinsulinemia, in order to restore the normal endocrinological and clinical parameters. Metformin (MET) is considered one of the first approaches to this pathology but new evidences are showing promising results using myo-inositol (MYO) in the management of this pathology...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28698075/comparison-of-metformin-and-n-acetyl-cysteine-as-an-adjuvant-to-clomiphene-citrate-in-clomiphene-resistant-women-with-polycystic-ovary-syndrome
#14
M Nemati, S Nemati, A-M Taheri, B Heidari
OBJECTIVE: To evaluate the effects of short- and long-term treatment with metformin and NAC, in an adjuvant to clomiphene citrate (CC), on the improvement of hormonal profile (SHBG, total testosterone, FBS, and fasting insulin) and fertility status in CC-resistant women with PCOS. MATERIALS AND METHODS: One hundred and eight CC-resistant PCOS patients participated in the study and received either metformin (1500mg/day) or NAC (1800mg/day) with 100mg/day of CC for 8 and 12 weeks...
July 8, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28694019/opportunities-to-reduce-diabetes-risk-in-women-of-reproductive-age-assessment-and-treatment-of-prediabetes-within-a-large-integrated-delivery-system
#15
Cassondra Marshall, Sara Adams, Wendy Dyer, Julie Schmittdiel
BACKGROUND: Preventing diabetes before pregnancy may be important to improve maternal and infant outcomes. Although the preconception period is a crucial time to focus on chronic disease prevention, little is known about preventive services for reproductive-aged women at risk of developing diabetes. METHODS: Using electronic health record data from patients at Kaiser Permanente Northern California, we identified 21,965 nonpregnant women aged 18 to 44 with incident prediabetes (PDM; fasting plasma glucose [FPG] = 100-125 or glycated hemoglobin A1c = 5...
July 7, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28691362/basal-bolus-insulin-therapy-reduces-maternal-triglycerides-in-gestational-diabetes-without-modifying-cholesteryl-ester-transfer-protein-activity
#16
Pablo R Olmos, Gisella R Borzone
AIM: Macrosomia in the offspring of overweight/obese mothers with glucose-controlled gestational diabetes mellitus (GDM) is due to excessive rise of maternal triglycerides (TG). We aimed to ascertain whether basal-bolus insulin therapy (BBIT), or other components of the treatment, could reduce TG in GDM. METHODS: We studied the records of 131 singleton pregnancies with GDM, using stepwise multiple linear regression, Mann-Whitney, χ(2) , and Jonckheere-Terpstra tests...
July 10, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28689771/immunosuppression-with-tacrolimus-improved-implantation-and-rescued-expression-of-uterine-progesterone-receptor-and-its-co-regulators-fkbp52-and-piasy-at-nidation-in-the-obese-and-diabetic-mice-comparative-studies-with-metformin
#17
Ahmad J H Albaghdadi, Frederick W K Kan
Diabesity is often associated with subfertility and recurrent miscarriages. Evidence links systemic and local uterine cytotoxicity to the pathogenesis of implantation failure (IF) in diabetes. Immunosuppression with tacrolimus improved pregnancy outcomes in obese and diabetic mice and repeated IF in women with elevated Th1/Th2 blood cell ratios. However the mode of action of tacrolimus in protecting against IF and the molecular mechanisms associated with recurrent miscarriages in the obese and diabetic subjects are yet to be elucidated...
July 6, 2017: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/28630466/comparative-effectiveness-of-9-ovulation-induction-therapies-in-patients-with-clomiphene-citrate-resistant-polycystic-ovary-syndrome-a-network-meta-analysis
#18
Yiping Yu, Lanlan Fang, Ruizhe Zhang, Jingyan He, Yujing Xiong, Xiaoyi Guo, Qingyun Du, Yan Huang, Yingpu Sun
The comparative efficacies of ovulation-induction treatments in patients with clomiphene citrate-resistant (CCR) polycystic ovary syndrome (PCOS) are not well known. Therefore, we conducted a network meta-analysis to rank the reproductive efficacies of these treatments. We ultimately included 26 randomized clinical trials with 2722 participants and 9 types of therapies: clomiphene citrate (CC), metformin, letrozole, follicle stimulating hormone (FSH), human menopausal gonadotropin (hMG), unilateral laparoscopic ovarian drilling (ULOD), bilateral laparoscopic ovarian drilling (BLOD), the combination of metformin with letrozole (metformin+letrozole), and the combination of metformin with CC (metformin+CC)...
June 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28619690/metformin-the-aspirin-of-the-21st-century-its%C3%A2-role-in-gestational-diabetes-mellitus-prevention-of-preeclampsia-and-cancer-and%C3%A2-the-promotion-of-longevity
#19
REVIEW
Roberto Romero, Offer Erez, Maik Hüttemann, Eli Maymon, Bogdan Panaitescu, Agustin Conde-Agudelo, Percy Pacora, Bo Hyun Yoon, Lawrence I Grossman
Metformin is everywhere. Originally introduced in clinical practice as an antidiabetic agent, its role as a therapeutic agent is expanding to include treatment of prediabetes mellitus, gestational diabetes mellitus, and polycystic ovarian disease; more recently, experimental studies and observations in randomized clinical trials suggest that metformin could have a place in the treatment or prevention of preeclampsia. This article provides a brief overview of the history of metformin in the treatment of diabetes mellitus and reviews the results of metaanalyses of metformin in gestational diabetes mellitus as well as the treatment of obese, non-diabetic, pregnant women to prevent macrosomia...
September 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28586507/patterns-of-glucose-lowering-therapies-and-neonatal-outcomes-in-the-treatment-of-gestational-diabetes-in-canada-2009-2014
#20
S L Bowker, A Savu, R O Yeung, J A Johnson, E A Ryan, P Kaul
AIM: To examine patterns of use of different glycaemic control agents for treating gestational diabetes mellitus. METHODS: This was a large, retrospective, population-based cohort study of pregnant women with gestational diabetes from Alberta, Canada. We linked data from the Alberta Vital Statistics - Birth database with administrative claims data. Alberta Vital Statistics - Birth data were used to identify births that occurred between 1 January 2009 and 31 December 2014...
September 2017: Diabetic Medicine: a Journal of the British Diabetic Association
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