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metformin in pregnancy

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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
#1
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-21-st-century-its-role-in-gestational-diabetes-prevention-of-preeclampsia-and-cancer-and-the-promotion-of-longevity
#2
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 anti-diabetic agent, its role as a therapeutic agent is expanding to include treatment of pre-diabetes, gestational diabetes, polycystic ovarian disease, and more recently, experimental studies, as well as 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, reviews the results of meta-analyses of metformin in gestational diabetes, and the treatment of obese non-diabetic pregnant women to prevent macrosomia...
June 12, 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
#3
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...
June 6, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28557652/comparison-of-clomiphene-citrate-and-letrozole-for-ovulation-induction-in-women-with-polycystic-ovary-syndrome-a-prospective-randomized-trial
#4
Chang Liu, Guimei Feng, Wei Huang, Qiuyi Wang, Shiyuan Yang, Jing Tan, Jing Fu, Dong Liu
To compare the therapeutic efficacy of clomiphene citrate (CC) and letrozole (LE) on ovulation, pregnancy, and live birth in women with polycystic ovary syndrome (PCOS); and to ensure if LE can replace CC as the first-line therapy for ovulation induction in these women. This is a prospectively, randomized, controlled trial in the tertiary hospital. Two-hundred and sixty-eight anovulatory PCOS patients were treated by CC or CC plus metformin and LE or LE plus metformin for three continuous cycles or conception; their ovulation rates, pregnancy rates, and live birth rates were calculated and compared...
May 30, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28544572/inositol-treatment-of-anovulation-in-women-with-polycystic-ovary-syndrome-a-meta-analysis-of-randomised-trials
#5
Jyotsna Pundir, Dimitrios Psaroudakis, Prakash Savnur, Priya Bhide, Luca Sabatini, Helena Teede, Arri Coomarasamy, Shakila Thangaratinam
BACKGROUND: Polycystic ovary syndrome is a common cause of anovulation and infertility, and a risk factor for development of metabolic syndrome and endometrial cancer. OBJECTIVES: Systematic review and meta-analysis of randomised controlled trials that evaluated the effects of inositol as an ovulation-induction agent. SEARCH STRATEGY: We searched MEDLINE, EMBASE, Cochrane and ISI conference proceedings, Register and Meta-register for RCTs and WHO trials' search portal...
May 24, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28544499/preventing-progression-from-gestational-diabetes-mellitus-to-diabetes-a-thought-filled-review
#6
REVIEW
Michal Kasher-Meron, Martin M Grajower
Women with a history of gestational diabetes (GDM) are at high risk for developing type 2 diabetes mellitus (T2DM). In studies with long periods of follow up, diabetes incidence of up to 70% has been reported. The appropriate follow up of women following a pregnancy complicated by GDM has not been studied. Published guidelines recommend that obstetrician/gynecologists, who are often the de facto primary care physicians for these otherwise healthy young women, make glucose monitoring in the post-partum period part of their annual examinations...
May 19, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28507380/malaria-and-diabetes
#7
Sanjay Kalra, Deepak Khandelwal, Rajiv Singla, Sameer Aggarwal, Deep Dutta
Both malaria and diabetes are more common in the developing world, and are major public health challenges. A direct relationship between these 2 conditions has not been evaluated. This review article assessed the literature guaging the relationship between these two conditions, and suggests a pragmatic approach to management. References for this review were identified through searches of PubMed, Medline, and Embase for articles published to October 2016 using the terms "diabetes" [MeSH Terms] AND "malaria" [All Fields]...
May 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28499531/gestational-diabetes-diagnosis-classification-and-clinical-care
#8
REVIEW
Lynn R Mack, Paul G Tomich
Gestational diabetes mellitus (GDM) affects approximately 6% of pregnant women, and prevalence is increasing in parallel with the obesity epidemic. Protocols for screening/diagnosing GDM are controversial with several guidelines available. Treatment of GDM results in a reduction in the incidence of preeclampsia, shoulder dystocia, and macrosomia. If diet and lifestyle changes do not result in target glucose levels, then treatment with metformin, glyburide, or insulin should begin. It is generally recommended that pregnancies complicated by GDM do not go beyond term...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28491872/incidence-and-contributing-factors-of-persistent-hyperglycemia-at-6-12-weeks-postpartum-in-iranian-women-with-gestational-diabetes-results-from-laga-cohort-study
#9
Sedigheh Nouhjah, Hajieh Shahbazian, Nahid Shahbazian, Alireza Jahanshahi, Shayesteh Jahanfar, Bahman Cheraghian
Background. A history of gestational diabetes is an important predictor of many metabolic disturbances later in life. Method. Life after gestational diabetes Ahvaz Study (LAGAs) is an ongoing population-based cohort study. Up to February 2016, 176 women with gestational diabetes underwent a 75 g oral glucose tolerance test (OGTT) at 6-12 weeks postpartum in Ahvaz (southwestern of Iran). Gestational diabetes was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and the American Diabetes Association (ADA) criteria applied for diagnosis of postpartum prediabetes and diabetes...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28474821/application-of-physiologically-based-pharmacokinetic-modeling-to-predict-drug-disposition-in-pregnant-populations
#10
Vamshi Krishna Jogiraju, Suvarchala Avvari, Rakesh Gollen, David R Taft
Pregnancy is associated with numerous physiologic changes that influence absorption, distribution, metabolism and excretion. Moreover, the magnitude of these effects changes as pregnancy matures. For most medications, there is limited information available about changes in drug disposition that can occur in pregnant patients, yet most women are prescribed one or more medications during pregnancy. In this investigation, PBPK modeling was used to assess the impact of pregnancy on the pharmacokinetic profiles of three medications (metformin, tacrolimus, oseltamivir) using the Simcyp® Simulator...
May 5, 2017: Biopharmaceutics & Drug Disposition
https://www.readbyqxmd.com/read/28367163/therapeutic-effects-of-metformin-and-clomiphene-in-combination-with-lifestyle-intervention-on-infertility-in-women-with-obese-polycystic-ovary-syndrome
#11
Jing Zhang, Qinqin Si, Jinqiong Li
OBJECTIVE: To evaluate the therapeutic effects of metformin and clomiphene in combination with lifestyle adjustment on infertility in women with obese polycystic ovarian syndrome (PCOS). METHODS: A total of 101 infertile women with obese PCOS admitted to our hospital from July 2013 to July 2015 were randomly divided into an observation group (n=51) and a control group (n=50). The control group was treated with metformin plus clomiphene, based on which the observation group was also subjected to lifestyle adjustment...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28366078/-the-myo-inositol-is-beneficial-in-the-therapy-of-pregnancy-with-insulin-dependent-type-2-diabetes-and-polycystic-ovary-syndrome
#12
Attila Kun, János Tornóczky
Authors would like to demonstrate the beneficial effect of myo-inositol supplementation in a pregnant woman with insulin-dependent type 2 diabetes mellitus and polycystic ovary syndrome. Insulin and metformin treatment could not achieve normalization of glucose homeostasis for 3 years, and hypoglycemic episodes were frequent. Myo-inositol and folic acid supplementation added to the basic treatment resulted in improved glucose levels in 2 months. At this time she became pregnant. During pregnancy serum glucose levels still improved in the next 2 months...
April 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28347542/managing-obesity-in-pregnancy-an-obstetric-and-midwifery-perspective
#13
Jodie M Dodd, Annette L Briley
Overweight and obesity during pregnancy and childbirth represent a significant health burden, placing women and their infants at increased risk of almost all documented adverse outcomes. Research efforts have focused on strategies to limit gestational weight gain, including dietary and lifestyle interventions, as well as the use of adjuvant therapies such as metformin. However, there remain many barriers to behavioural change for women during pregnancy, and current care recommendations largely reflect good clinical practice, rather than being based on strong evidence...
June 2017: Midwifery
https://www.readbyqxmd.com/read/28244019/effect-of-metformin-and-oral-contraceptives-on-polycystic-ovary-syndrome-and-ivf-cycles
#14
M N Kalem, Z Kalem, T Gurgan
AIM: The aim of this study is to investigate the effect of metformin and/or OC added to the treatment of PCOS patients at our clinic on IVF outcome. MATERIALS AND METHODS: This study is a retrospective study that assesses the data of PCOS patients who received IVF between 2005 and 2015 at a private IVF center. The study included 496 PCOS cases aged between 24 and 40. Participants diagnosed with PCOS were divided into 4 groups according to the use of metformin and OC prior to the IVF cycle: 11...
February 27, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28236849/should-metformin-be-included-in-fertility-treatment-of-pcos-patients
#15
Jigal Haas, Yaakov Bentov
Metformin, a drug developed for the treatment of patients with type II diabetes, has become commonly prescribed medication for PCOS patients. Initially, metformin was prescribed for patients with impaired glucose tolerance at the pre conception period, however more recently its use was expanded to many of the PCOS patients and for the whole duration of pregnancy. Several studies examining the effects of Metformin during pregnancy reported a lower pregnancy loss, reduced gestational diabetes and no increased risk for birth defects, however, several more recent studies also raised concerns about its safe use...
March 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28193233/tacrolimus-in-the-prevention-of-adverse-pregnancy-outcomes-and-diabetes-associated-embryopathies-in-obese-and-diabetic-mice
#16
Ahmad J H Albaghdadi, Melanie A Hewitt, Samantha M Putos, Michael Wells, Terence R S Ozolinš, Frederick W K Kan
BACKGROUND: T2DM is a high-risk pregnancy with adverse fetal and maternal outcomes including repeated miscarriages and fetal malformations. Despite the established association between placental insufficiency and poor maternal Th1-adaptability to the development of pregnancy complications in T2DM, there have been no established data to assess benefits of pre-pregnancy immunosuppression relative to gestational outcomes in T2DM. We hypothesized that pre-pregnancy macrolide immune suppression can re-establish normal placental development and uterine vascular adaptation in a mouse model of obesity-associated T2DM...
February 13, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28179448/the-igf-system-in-patients-with-type-2-diabetes-associations-with-markers-of-cardiovascular-target-organ-damage
#17
Rikke Hjortebjerg, Esben Laugesen, Pernille Høyem, Claus Oxvig, Brian Stausbøl-Grøn, Søren T Knudsen, Won Y Kim, Per L Poulsen, Troels K Hansen, Mette Bjerre, Jan Frystyk
OBJECTIVE: Perturbations in the insulin-like growth factor (IGF) system may contribute to the accelerated cardiovascular disease (CVD) that occurs in patients with type 2 diabetes (T2D). However, it remains unknown whether the IGF system is also involved in the development of early, subclinical CVD. We characterised the IGF system in T2D patients and matched controls and examined the associations with markers of subclinical target organ damage. METHODS: The study included 99 patients with recently diagnosed T2D and 99 age- and sex-matched controls...
May 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28143834/treatment-strategies-for-women-with-who-group-ii-anovulation-systematic-review-and-network-meta-analysis
#18
REVIEW
Rui Wang, Bobae V Kim, Madelon van Wely, Neil P Johnson, Michael F Costello, Hanwang Zhang, Ernest Hung Yu Ng, Richard S Legro, Siladitya Bhattacharya, Robert J Norman, Ben Willem J Mol
OBJECTIVE:  To compare the effectiveness of alternative first line treatment options for women with WHO group II anovulation wishing to conceive. DESIGN:  Systematic review and network meta-analysis. DATA SOURCES:  Cochrane Central Register of Controlled Trials, Medline, and Embase, up to 11 April 2016. STUDY SELECTION:  Randomised controlled trials comparing eight ovulation induction treatments in women with WHO group II anovulation: clomiphene, letrozole, metformin, clomiphene and metformin combined, tamoxifen, gonadotropins, laparoscopic ovarian drilling, and placebo or no treatment...
January 31, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28127850/the-emerging-role-of-metformin-in-gestational-diabetes-mellitus
#19
REVIEW
Susan G Gray, Treasure M McGuire, Neale Cohen, Peter J Little
Metformin use during pregnancy is controversial and there is disparity in the acceptance of metformin treatment in women with gestational diabetes mellitus (GDM) in Australia. Despite short term maternal and neonatal safety measures, the placental transfer of metformin during GDM treatment and the absence of long-term safety data in offspring has regulators and prescribers cautious about its use. To determine the current role in GDM management, this literature review describes the physiological changes that occur in GDM and other forms of diabetes in pregnancy (DIP) and international changes in guidelines for GDM diagnosis...
June 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28120427/oral-anti-diabetic-pharmacological-therapies-for-the-treatment-of-women-with-gestational-diabetes
#20
REVIEW
Julie Brown, Ruth Martis, Brenda Hughes, Janet Rowan, Caroline A Crowther
BACKGROUND: Gestational diabetes mellitus (GDM) is a major public health issue with rates increasing globally. Gestational diabetes, glucose intolerance first recognised during pregnancy, usually resolves after birth and is associated with short- and long-term complications for the mother and her infant. Treatment options can include oral anti-diabetic pharmacological therapies. OBJECTIVES: To evaluate the effects of oral anti-diabetic pharmacological therapies for treating women with GDM...
January 25, 2017: Cochrane Database of Systematic Reviews
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