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https://www.readbyqxmd.com/read/29749110/metformin-for-the-prevention-of-hypertensive-disorders-of-pregnancy-in-women-with-gestational-diabetes-and-obesity-a-systematic-review-and-meta-analysis
#1
REVIEW
Erkan Kalafat, Yavuz Emre Sukur, Abdulkadir, Basky Thilaganathan, Asma Khalil
OBJECTIVES: Metformin has been reported to reduce the risk of preeclampsia. It is also known to influence soluble fms-like tyrosine kinase-1 (sFlt-1) levels, which correlate significantly with the gestation of onset and severity of preeclampsia. The main aim of this systematic review and meta-analysis was to determine whether metformin use is associated with the incidence of hypertensive disorders of pregnancy (HDP). METHODS: MEDLINE (1947 - September 2017), Scopus (1970 - September 2017) and the Cochrane Library (since inception - September 2017) were searched for relevant citations in English language...
May 10, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29739273/angiogenic-dysregulation-in-pregnancy-related-hypertension-a-role-for-metformin
#2
Nerolen Soobryan, Saravanakumar Murugesan, Arunagiri Pandiyan, Jagidesa Moodley, Irene Mackraj
In the face of escalating maternal and fetal health threats, hypertensive pregnancy disorders (HPDs) is one of the leading cause of maternal and fetal morbidity and mortality. The range of HPDs include white-coat hypertension, chronic hypertension, gestational hypertension, mild-to-moderate and severe preeclampsia and eclampsia. Current evidence implicates an imbalance of circulating anti- and angiogenic factors in HPDs emanating from the placental vasculature, impacting on angiogenesis. Delivery of the fetus is thus far the only curative measure, albeit with increased risk...
January 1, 2018: Reproductive Sciences
https://www.readbyqxmd.com/read/29709497/reduced-cortical-excitability-neuroplasticity-and-salivary-cortisol-in-11-13-year-old-children-born-to-women-with-gestational-diabetes-mellitus
#3
Jago M Van Dam, Amy J Garrett, Luke A Schneider, Nicolette A Hodyl, Mitchell R Goldsworthy, Suzette Coat, Janet A Rowan, William M Hague, Julia B Pitcher
BACKGROUND: Children exposed to gestational diabetes mellitus (GDM) in utero are at increased risk of neurodevelopmental difficulties, including autism and impaired motor control. However, the underlying neurophysiology is unknown. METHODS: Using transcranial magnetic stimulation, we assessed cortical excitability, long-term depression (LTD)-like neuroplasticity in 45 GDM-exposed and 12 control children aged 11-13 years. Data were analysed against salivary cortisol and maternal diabetes severity and treatment (insulin [N = 22] or metformin [N = 23]) during pregnancy...
April 10, 2018: EBioMedicine
https://www.readbyqxmd.com/read/29702716/effectiveness-of-metformin-in-the-prevention-of-gestational-diabetes-mellitus-in-obese-pregnant-women
#4
Willian Barbosa Sales, Iramar Baptistella do Nascimento, Guilherme Dienstmann, Matheus Leite Ramos de Souza, Grazielle Dutra da Silva, Jean Carl Silva
OBJECTIVE:  To assess the effectiveness of metformin in the incidence of gestational diabetes mellitus (GDM) in obese pregnant women attending a public maternity hospital in Joinville, Santa Catarina, Brazil. METHODS:  Randomized clinical trial including obese pregnant women with a body mass index (BMI) ≥ 30 kg/m2 , divided into two groups (control and metformin). Both groups received guidance regarding diet and physical exercise. The participants were assessed at two moments, the first at enrollment (gestational age ≤ 20) and the second at gestational weeks 24-28...
April 27, 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29682291/metformin-in-gestational-diabetes-the-offspring-follow-up-mig-tofu-body-composition-and-metabolic-outcomes-at-7-9-years-of-age
#5
Janet A Rowan, Elaine C Rush, Lindsay D Plank, Jun Lu, Victor Obolonkin, Suzette Coat, William M Hague
Objective: To compare body composition and metabolic outcomes at 7-9 years in offspring of women with gestational diabetes (GDM) randomized to metformin (±insulin) or insulin treatment during pregnancy. Research design and methods: Children were assessed at 7 years in Adelaide (n=109/181) and 9 years in Auckland (n=99/396) by anthropometry, bioimpedance analysis (BIA), dual-energy X-ray absorptiometry (DXA), magnetic resonance imaging (MRI) (n=92/99) and fasting bloods (n=82/99)...
2018: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/29679622/pharmacotherapy-for-hyperglycemia-in-pregnancy-do-oral-agents-have-a-place
#6
REVIEW
Rosa Corcoy, Montserrat Balsells, Apolonia García-Patterson, Anat Shmueli, Eran Hadar
Diabetes is a frequent condition in pregnancy and achieving adequate glycemic control is of paramount importance. Insulin treatment is the gold standard, oral agents are more attractive, but their safety and efficiency should be a prerequisite for their use. We have more information regarding treatment of women with gestational diabetes mellitus where glyburide can induce a picture of fetal hyperinsulinism (higher birthweight and more neonatal hypoglycemia) whereas metformin requires supplemental insulin in a larger proportion of women but achieves satisfactory perinatal outcomes with the exception of preterm birth...
April 18, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29677194/combined-intervention-of-swimming-plus-metformin-ameliorates-the-insulin-resistance-and-impaired-lipid-metabolism-in-murine-gestational-diabetes-mellitus
#7
Liping Huang, Pingping Yue, Xuefei Wu, Ting Yu, Yang Wang, Ji Zhou, Derun Kong, Keyang Chen
Gestational diabetes mellitus (GDM) has short- and long- term influence on pregnant women and fetus. Swimming, as an aerobic exercise, can effectively improve the blood glucose level in GDM, but the effect of mild swimming alone was not very substantial. Metformin, as an oral antidiabetic drug, has obvious hypoglycemic effect, and is economic also, but the long-term effect on pregnant women and fetus has not been completely clear. We hypothesize that combined intervention of mild swimming and low dose of metformin, may effectively reduce blood glucose, improve the pregnancy outcomes in GDM dams, but simultaneously avoiding the adverse effects caused by overdose of drug and impotence of mild swimming...
2018: PloS One
https://www.readbyqxmd.com/read/29627447/gestational-diabetes-mellitus-multi-disciplinary-treatment-approaches
#8
Evangelia Kintiraki, Dimitrios G Goulis
Gestational Diabetes Mellitus (GDM) is the most common metabolic disease of pregnancy, associated with several perinatal complications. Adequate glycemic control has been proved to decrease risk of GDM-related complications. Several studies have shown the beneficial effect of exercise and medical nutrition treatment on glycemic and weight control in GDM-affected women. Moreover, pharmacological agents, such as insulin and specific oral anti-diabetic agents can be prescribed safely during pregnancy, decreasing maternal blood glucose and, thus, perinatal adverse outcomes...
April 5, 2018: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/29614026/prenatal-metformin-therapy-attenuates-hypertension-of-developmental-origin-in-male-adult-offspring-exposed-to-maternal-high-fructose-and-post-weaning-high-fat-diets
#9
You-Lin Tain, Kay L H Wu, Wei-Chia Lee, Steve Leu, Julie Y H Chan
Widespread consumption of a Western diet, comprised of highly refined carbohydrates and fat, may play a role in the epidemic of hypertension. Hypertension can take origin from early life. Metformin is the preferred treatment for type 2 diabetes. We examined whether prenatal metformin therapy can prevent maternal high-fructose plus post-weaning high-fat diets-induced hypertension of developmental origins via regulation of nutrient sensing signals, uric acid, oxidative stress, and the nitric oxide (NO) pathway...
April 3, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29576523/predictors-of-metformin-failure-in-gestational-diabetes-mellitus-gdm
#10
May Oo Khin, Simon Gates, Ponnusamy Saravanan
INTRODUCTION AND OBJECTIVE: The role of metformin in gestational diabetes mellitus (GDM) is also increasing. However, almost half of metformin-treated women required additional insulin. Therefore, identifying the characteristics of these women may help define optimal therapeutic strategy. METHODS: This is a retrospective cohort study done in a District General Hospital, UK. GDM was diagnosed by 75 g OGTT test between 24 and 28 weeks of gestation with fasting levels of ≥6...
May 2018: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/29573162/changing-environment-of-hyperglycemia-in-pregnancy-gestational-diabetes-and-diabetes-mellitus-in-pregnancy
#11
REVIEW
Susan G Gray, Arianne N Sweeting, Treasure M Mcguire, Neale Cohen, Glynis P Ross, Peter J Little
The diagnosis and treatment of gestational diabetes mellitus (GDM) have been in a state of flux since the World Health Organization accepted and endorsed the International Diabetes and Pregnancy Study Group's diagnostic pathway and criteria in 2013. These new diagnostic criteria identify an increasing number of women at risk of hyperglycemia in pregnancy (HGiP). Maternal hyperglycemia represents a significant risk to the mother and fetus, in both the short and long term. Controversially, metformin use for the treatment of GDM is increasing in Australia...
March 23, 2018: Journal of Diabetes
https://www.readbyqxmd.com/read/29561188/short-term-sitagliptin-metformin-therapy-is-more-effective-than-metformin-or-placebo-in-prior-gestational-diabetic-women-with-impaired-glucose-regulation
#12
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
https://www.readbyqxmd.com/read/29524482/the-effects-of-metformin-on-maternal-haemodynamics-in-gestational-diabetes-mellitus-a-pilot-study
#13
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...
May 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29522471/outcomes-for-women-with-gestational-diabetes-treated-with-metformin-a-retrospective-case-control-study
#14
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
https://www.readbyqxmd.com/read/29499921/pharmacological-treatment-of-gestational-diabetes-mellitus-point-counterpoint
#15
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...
May 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29490031/metformin-use-in-pcos-pregnancies-increases-the-risk-of-offspring-overweight-at-4-years-of-age-follow-up-of-two-rcts
#16
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
https://www.readbyqxmd.com/read/29421161/therapies-for-gestational-diabetes-and-their-implications-for-maternal-and-offspring-health-evidence-from-human-and-animal-studies
#17
REVIEW
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...
April 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29399540/drug-interactions-of-metformin-involving-drug-transporter-proteins
#18
REVIEW
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
https://www.readbyqxmd.com/read/29339526/the-diversity-of-gestational-diabetes-a-therapeutic-challenge
#19
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
https://www.readbyqxmd.com/read/29325773/how-safe-is-metformin-when-initiated-in-early-pregnancy-a-retrospective-5-year-study-of-pregnant-women-with-gestational-diabetes-mellitus-from-india
#20
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)...
March 2018: Diabetes Research and Clinical Practice
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