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gestational diabetes metformin

Karen E Elkind-Hirsch, Martha S Paterson, Donna Shaler, Hanh C Gutowski
OBJECTIVE: Our pilot study examined the effectiveness of sitagliptin-metformin (SITA-MET), metformin (MET), and placebo (P) therapy on fasting and post-glucose challenge glucose levels in postpartum women with prior gestational diabetes mellitus (GDM) and impaired glucose regulation. METHODS: Prediabetic women (N = 36, age 18 to 42 years) with recent GDM were randomized to P (one pill twice a day), MET (1,000 mg twice a day), or SITA-MET (50 mg SITA, 1,000 mg MET twice a day) for 16 weeks in a single-blind fashion...
March 21, 2018: Endocrine Practice
Mohamed Waseem Osman, Mintu Nath, Asma Khalil, David R Webb, Thompson G Robinson, Hatem A Mousa
BACKGROUND: Gestational diabetes mellitus (GDM) is a major clinical challenge and is likely to remain so as the incidence of GDM continues to increase AIM: To assess longitudinal changes in maternal haemodynamics amongst women diagnosed with GDM requiring either metformin or dietary intervention in comparison to low-risk healthy controls. METHODOLOGY: Fifty-six pregnant women attending their first appointment at the GDM clinic and 60 low-risk healthy pregnant controls attending their routine antenatal clinics were recruited and assigned to three groups: GDM Metformin (GDM-M), GDM Diet (GDM-D) and Control...
March 7, 2018: Diabetes Research and Clinical Practice
Rachel T McGrath, Sarah J Glastras, Emma S Scott, Samantha L Hocking, Gregory R Fulcher
Metformin is increasingly being used a therapeutic option for the management of gestational diabetes mellitus (GDM). The aim of this study was to compare the maternal characteristics and perinatal outcomes of women with GDM treated with metformin (with or without supplemental insulin) with those receiving other management approaches. A retrospective, case-control study was carried out and 83 women taking metformin were matched 1:1 with women receiving insulin or diet and lifestyle modification alone. Women managed with diet and lifestyle modification had a significantly lower fasting plasma glucose ( p < 0...
March 9, 2018: Journal of Clinical Medicine
Oded Langer
Controversies persist over the most efficacious pharmacologic treatment for gestational diabetes mellitus. For purposes of accuracy in this article, the individual American College of Obstetricians and Gynecologists Practice Bulletin and American Diabetes Association Standards of Medical Care positions on each issue are quoted and then deliberated with evidence of counter claims presented in point/counterpoint. This is a review of all the relevant evidence for the most holistic picture possible. The main issues are (1) which diabetic drugs cross the placenta, (2) the quality of evidence and data source validity, (3) the rationale for the designation of glucose control as the primary outcome in gestational diabetes mellitus, and (4) which drugs (metformin, glyburide, or insulin) are most effective in improving secondary outcomes...
February 28, 2018: American Journal of Obstetrics and Gynecology
Liv Guro Engen Hanem, Solhild Stridsklev, Pétur B Júlíusson, Øyvind Salvesen, Mathieu Roelants, Sven M Carlsen, Rønnaug Ødegård, Eszter Vanky
Context: Metformin is used in pregnancy in women with gestational diabetes mellitus, polycystic ovary syndrome (PCOS) and obesity. Metformin passes the placenta. Objective: To explore the effects of metformin use in PCOS pregnancies on offspring growth to 4 years of age. Design: Follow-up study of two randomized, double blind, placebo-controlled trials. Setting: Secondary care centers. Eleven public hospitals in Norway...
February 27, 2018: Journal of Clinical Endocrinology and Metabolism
Gabriel M Brawerman, Vernon W Dolinsky
Obesity prior to and during pregnancy is associated with an increased risk of complications during pregnancy. One of the most common complications of pregnancy is gestational diabetes mellitus (GDM), a condition characterized by hyperglycemia and insulin resistance that is diagnosed in the third trimester of pregnancy. GDM predisposes both mothers and their children to increased obesity and cardiometabolic disorders, namely type 2 diabetes and cardiovascular disease. Current treatments include lifestyle changes and insulin injections, but oral anti-diabetic drugs such as metformin and glyburide are increasingly prescribed as they do not require injections...
February 5, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Naina Mohamed Pakkir Maideen, Abdurazak Jumale, Rajkapoor Balasubramaniam
Metformin is a most widely used medication all around the world to treat Type 2 diabetes mellitus. It is also found to be effective against various conditions including, Prediabetes, Gestational diabetes mellitus (GDM), Polycystic Ovarian Syndrome (PCOS), Obesity, Cancer, etc. It is a cationic drug and it depends Organic Cation Transporters (OCTs) and Multidrug and Toxin Extruders (MATEs) mostly for its pharmacokinetics movement. The probability of drug interaction increases with the number of concomitant medications...
December 2017: Advanced Pharmaceutical Bulletin
Elisabeth Qvigstad
Metformin as the first drug of choice for glucose lowering in gestational diabetes (GDM) is still controversial, despite recent publications reporting similar outcomes in comparison to insulin, both for offspring and mothers. The use of metformin during pregnancy is increasing and several recent guidelines recommend metformin use in GDM pregnancies. Background, current metformin use and unresolved concerns are discussed in the context of the article from Gante and coworkers.
March 2018: European Journal of Endocrinology
Vanlalhruaii, Riddhi Dasgupta, Roshna Ramachandran, Jiji E Mathews, Annie Regi, Niranjan Thomas, Vijay Gupta, P Visalakshi, H S Asha, Thomas Paul, Nihal Thomas
BACKGROUND: The initiation of metformin in early pregnancy in Gestational Diabetes mellitus (GDM) remains controversial. The aim of our study was to assess the influence of Metformin on maternal and fetal outcomes when initiated within the first trimester of pregnancy in GDM. METHODS AND MATERIALS: A retrospective analysis of 540 women with diabetes complicating pregnancy (IADPSG criteria) over five years (January 2011 to May 2016) was done. The study population comprised of patients initiated on (a) metformin within the first trimester (Group A:n = 186), (b) metformin after the first trimester (Group B:n = 203) and (c) insulin at any time during their pregnancy (Group C:n = 151)...
January 8, 2018: Diabetes Research and Clinical Practice
AbdelHameed Mirghani Dirar, John Doupis
Gestational diabetes mellitus (GDM) is defined as any degree of hyperglycaemia that is recognized for the first time during pregnancy. This definition includes cases of undiagnosed type 2 diabetes mellitus (T2DM) identified early in pregnancy and true GDM which develops later. GDM constitutes a greater impact on diabetes epidemic as it carries a major risk of developing T2DM to the mother and foetus later in life. In addition, GDM has also been linked with cardiometabolic risk factors such as lipid abnormalities, hypertensive disorders and hyperinsulinemia...
December 15, 2017: World Journal of Diabetes
Sedigheh Nouhjah, Hajieh Shahbazian, Nahid Shahbazian, Shayesteh Jahanfar, Alireza Jahanshahi, Bahman Cheraghian, Zeinab Dehghan Mohammadi, Niloofar Ghodrati, Sousan Houshmandi
AIMS: This study aimed to determine the prevalence rate of metabolic syndrome and its potential risk factors, 6-12 weeks postpartum in women with GDM compared to women with normal glucose tolerance. METHODS: LAGAs is an ongoing population-based prospective cohort study that started in March 2015 in Ahvaz, Iran. During 11 months of study progression, 176 women with GDM pregnancy and 86 healthy women underwent a fasting glucose test, 75-g OGTT and fasting lipid tests at 6-12 weeks postpartum...
December 22, 2017: Diabetes & Metabolic Syndrome
Bharti Kalra, Sanjay Kalra, Meenu Choudhary, Meenakshi Thakral
Gestational diabetes mellitus (GDM) is common in pregnancy. Epidemiological studies have described the prevalence of GDM in the antenatal period, but do not assess the number of women who require pharmacological therapy at term. This information is important for obstetric care providers and health planners. We reviewed indoor charts of all women admitted for delivery at a maternity center in Karnal, Haryana, India. Of the 569 participants, 0.87% had preexisting diabetes, while 1.93% were being treated with drugs for GDM (0...
November 2017: Indian Journal of Endocrinology and Metabolism
Sara Fill Malfertheiner, Dagmar Gutknecht, Monika Bals-Pratsch
Background: A hyperglycemic metabolic status with insulin resistance can have a negative effect on fertility and pregnancy outcomes. The aim of this retrospective study was to investigate disorders of glucose and insulin metabolism in women wanting to conceive who conceived spontaneously prior to planned assisted reproduction (ART). Associated risk factors of patients in terms of live births and miscarriages were also analyzed. Method: Out of total study population of 589 pregnancies, the pregnancies of 129 women wishing to have children who conceived spontaneously prior to planned ART were analyzed in more detail...
December 2017: Geburtshilfe und Frauenheilkunde
Jyoti Balani, Steve Hyer, Argyro Syngelaki, Ranjit Akolekar, Kypros H Nicolaides, Antoinette Johnson, Hassan Shehata
Objectives: To examine whether the reduced incidence of preeclampsia in non-diabetic obese pregnant women treated with metformin is mediated by changes in insulin resistance. Methods: This was a secondary analysis of obese pregnant women in a randomised trial (MOP trial). Fasting plasma glucose and insulin were measured in 384 of the 400 women who participated in the MOP trial. Homeostasis model assessment of insulin resistance (HOMA-IR) was compared in the metformin and placebo groups and in those that developed preeclampsia versus those that did not develop preeclampsia...
December 2017: Obstetric Medicine
Alice Panchaud, Valentin Rousson, Thierry Vial, Nathalie Bernard, David Baud, Emmanuelle Amar, Marco De Santis, Alessandra Pistelli, Anne Dautriche, Frederique Beau-Salinas, Matteo Cassina, Hannah Dunstan, Anneke Passier, Yusuf Cem Kaplan, Mine Kadioglu Duman, Eva Maňáková, Georgios Eleftheriou, Gil Klinger, Ursula Winterfeld, Laura E Rothuizen, Thierry Buclin, Chantal Csajka, Sonia Hernandez-Diaz
AIMS: Metformin is used to treat type 2 diabetes, polycystic ovary syndrome associated infertility, and gestational diabetes. This study aims to evaluate the safety of metformin in early pregnancy. METHOD: We evaluated the risk of major birth defects and pregnancy losses in a cohort of pregnant women exposed to metformin during the first trimester for different indications relative to a matched unexposed reference group. RESULTS: The risk of major birth defects was 5...
March 2018: British Journal of Clinical Pharmacology
Amanda Ali, Sangeetha Shastry, Ratnasingam Nithiyananthan, Amira Ali, Ramesh Ganapathy
OBJECTIVE: Evaluate patient characteristics that are predictors of treatment response and outcomes in gestational diabetes STUDY DESIGN: Retrospective cohort of 265 women with gestational diabetes treated with diet/metformin and/or insulin in a single centre over 2 years. RESULTS: Multinomial logistic regression showed that (after adjusting for age and ethnicity) women who were of normal weight were more likely to be on diet and women who were obese were more likely to be on metformin or metformin and insulin(p=0...
January 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Oscar A Viteri, Mary Alice Sallman, Pauline M Berens, Pamela D Berens, Farah H Amro, Maria S Hutchinson, Susan M Ramin, Sean C Blackwell, Jerrie S Refuerzo, Judith A Smith
Objective: Pregnancy is associated with an increase in total cholesterol, high density lipoproteins (HDL), and low-density lipoproteins (LDL). Postpartum, HDL and LDL decrease over the first 12 weeks postpartum. Oxidized LDL (ox-LDL) is a marker of oxidative stress-related inflammation, which is associated with obesity and also with development of cardiovascular disease. Cardiovascular protection and weight loss are benefits from metformin, especially in women with diabetes. The objective of this study was to compare changes in lipid profiles and biomarkers for obesity during the initial 6 weeks postpartum between women with gestational diabetes mellitus (GDM) treated with metformin versus placebo...
2017: Frontiers in Medicine
Rabia Arshad, Samia Khanam, Fuad Shaikh, Nasim Karim
Objective: To evaluate and compare feto-maternal outcomes and glycemic control in metformin versus insulin treated gestational diabetics. Methods: The study was conducted in 2010- 2012 as a part of M. Phil at Civil hospital, Lyari General Hospital and Mamji Hospital in Karachi. After written informed consent, 71 GDM diagnosed females with WHO criteria were enrolled. They were divided into two groups. Group-A, 32 females were given oral metformin 500 mg TDS while Group-B, 39 females were given insulin 0...
September 2017: Pakistan Journal of Medical Sciences Quarterly
Claudia Caissutti, Gabriele Saccone, Andrea Ciardulli, Vincenzo Berghella
INTRODUCTION: There is inconclusive evidence from randomized controlled trials (RCTs) to support any specific criteria for pharmacologic therapy dose adjustment in diabetes in pregnancy. Our objective was to analyze the criteria for dose adjustment of pharmacologic treatment for diabetes mellitus (DM) in pregnancy. MATERIAL AND METHODS: Data sources: MEDLINE, OVID and Cochrane Library were searched from their inception to September 2017. Selection criteria included all trials of DM in pregnancy managed by oral hypoglycemic agents or insulin reporting criteria for pharmacologic therapy dose adjustment...
November 10, 2017: Acta Obstetricia et Gynecologica Scandinavica
Maria Brzozowska, Ewa Bieniek, Konrad Szosland, Andrzej Lewinski
Gestational diabetes (GDM) is a relatively common complication of pregnancy. Maternal hyperglycemia causes many serious side effects for mothers, fetuses and newborns. In 90% of women diagnosed with GDM, a dietary treatment results in satisfactory levels of blood glucose. The remaining 10% require insulin therapy to achieve the recommended glycemic levels. The majority of recent studies show the efficiency of metformin in gestational diabetes and prove that it is not a cause for any harmful side effects to the embryo and/or fetus...
October 2017: Neuro Endocrinology Letters
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