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gestational diabetes metformin

Riki Bergel, Eran Hadar, Yoel Toledano, Moshe Hod
Gestational diabetes mellitus (GDM) is one of the most common morbidities complicating pregnancy, with short- and long-term consequences to the mothers, fetuses, and newborns. Management and treatment are aimed to achieve best possible glycemic control, while avoiding hypoglycemia and ensuring maternal and fetal safety. It involves behavioral modifications, nutrition and medications, if needed; concurrent with maternal and fetal surveillance for possible adverse outcomes. This review aims to elaborate on the pharmacological options for GDM therapy...
November 2016: Current Diabetes Reports
Claire L Meek
Gestational diabetes (GDM) is a common pregnancy disorder which is generally managed with diet, exercise, metformin or insulin treatment and which usually resolves after delivery of the infant. Identifying and treating GDM improves maternal and fetal outcomes, and allows for health promotion to reduce the mother's risk of type 2 diabetes in later life. However, there remains considerable controversy about the optimal method of identification and diagnosis of women with GDM. The NICE-2015 diagnostic criteria (75g oral glucose tolerance test (OGTT) 0 hr ⩾5...
September 28, 2016: Annals of Clinical Biochemistry
Xingrong Tan, Shengbing Li, Ying Chang, Chao Fang, Hua Liu, Xingping Zhang, Yi Wang
PURPOSE: Some previous studies have found that continued metformin use is beneficial in the management of polycystic ovary syndrome (PCOS) in pregnant women. A systemic review and meta-analysis were needed to more fully assess the effects of metformin on pregnant PCOS patients. METHODS: The literature was fully searched using MEDLINE, EMBASE, SCOPUS, and COCHRANE for continued metformin use during pregnancy in women with PCOS. A systematic review and meta-analysis were performed to evaluate the comprehensive effects of continued metformin treatment on pregnancy-related outcomes in these women...
2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
Xian-Ling Zeng, Ya-Fei Zhang, Quan Tian, Yan Xue, Rui-Fang An
AIM: The aim of the study is to evaluate the effects of metformin on pregnancy outcomes in women with polycystic ovary syndrome (PCOS). METHODS: We searched electronic databases and bibliographies of relevant papers to identify studies comparing the pregnancy outcomes in the metformin group with those in the placebo or blank control group. Then, we did this meta-analysis based on the PRISMA guidelines. The primary outcomes included early pregnancy loss (EPL), preterm delivery, term delivery, and gestational diabetes mellitus (GDM)...
September 2016: Medicine (Baltimore)
Hend S Saleh, Walid A Abdelsalam, Hala E Mowafy, Azza A Abd ElHameid
Gestational diabetes mellitus (GDM) complicates a significant number of pregnancies. Blood glucose control improves perinatal outcomes. Medical nutrition therapy is the foundation in management. Aim of This Study. To evaluate efficacy of metformin in comparison to insulin for managing GDM. Methods. In prospective randomized comparative study, 150 antenatal women whose pregnancies had been complicated by GDM and did not respond to diet alone were recruited from antenatal clinics at Obstetrics Department in Zagazig University Hospitals from November 2012 to December 2014...
2016: International Journal of Reproductive Medicine
Ye Feng, Huixia Yang
Metformin has been gradually used in the management of gestational diabetes mellitus (GDM). In order to prove the safety and efficacy of metformin used in pregnancy, we searched several databases for the reports of randomized trials comparing insulin and metformin used in GDM and conducted a meta-analysis. Data showed the rates of neonatal large for gestational age, cesarean section, neonatal respiratory distress and preterm birth were similar in both groups. Maternal glycated hemoglobin-% at gestational week 36-37 was significantly lower in metformin group, indicating good glycemic control of metformin...
September 9, 2016: Journal of Maternal-fetal & Neonatal Medicine
Maritza T Farrant, Kathryn Williamson, Malcolm Battin, William M Hague, Janet A Rowan
We compared, in 733 women with gestational diabetes mellitus treated with metformin and/or insulin, rates of neonatal hypoglycaemia in those who had received a dextrose/insulin infusion during labour and prior to delivery (n = 132) with those who did not (n = 601). Women who had infusions were more likely to have been treated with insulin (87.1% vs 70.4%, P < 0.01) and have higher mean capillary glucose values (measured four times daily) in the two weeks prior to delivery (P < 0.01). They had lower mean (SD) glucose values in the 12 h prior to delivery (5...
August 17, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Denice S Feig, Kellie Murphy, Elizabeth Asztalos, George Tomlinson, Johanna Sanchez, Bernard Zinman, Arne Ohlsson, Edmond A Ryan, I George Fantus, Anthony B Armson, Lorraine L Lipscombe, Jon F R Barrett
BACKGROUND: The incidence of type 2 diabetes in pregnancy is rising and rates of serious adverse maternal and fetal outcomes remain high. Metformin is a biguanide that is used as first-line treatment for non-pregnant patients with type 2 diabetes. We hypothesize that metformin use in pregnancy, as an adjunct to insulin, will decrease adverse outcomes by reducing maternal hyperglycemia, maternal insulin doses, maternal weight gain and gestational hypertension/pre-eclampsia. In addition, since metformin crosses the placenta, metformin treatment of the fetus may have a direct beneficial effect on neonatal outcomes...
2016: BMC Pregnancy and Childbirth
Amanda L da Silva, Augusto R do Amaral, Daniela S de Oliveira, Lisiane Martins, Mariana R E Silva, Jean Carl Silva
OBJECTIVES: To compare different neonatal outcomes according to the different types of treatments used in the management of gestational diabetes mellitus (GDM). METHODS: This was a retrospective cohort study. The study population comprised pregnant women with GDM treated at a public maternity hospital from July 2010 to August 2014. The study included women aged at least 18 years, with a singleton pregnancy, who met the criteria for GDM. Blood glucose levels, fetal abdominal circumference, body mass index and gestational age were considered for treatment decision-making...
June 28, 2016: Jornal de Pediatria
Manni Mohanraj Mahalakshmi, Balaji Bhavadharini, Kumar Maheswari, Gunasekaran Kalaiyarasi, Ranjit Mohan Anjana, Unnikrishnan Ranjit, Viswanathan Mohan, Kurian Joseph, Kurian Rekha, Sivagnanam Nallaperumal, Belma Malanda, Arivudainambi Kayal, Anne Belton, Ram Uma
AIM: To compare the existing maternal and fetal outcomes in Asian Indian women with or without gestational diabetes mellitus (GDM) before the development of the Women in India with GDM Strategy (WINGS) GDM model of care (MOC). MATERIALS AND METHODS: Records of pregnant women were extracted retrospectively from three maternity centers in Chennai. GDM was diagnosed using the International Association for Pregnancy Study Groups criteria or the Carpenter and Coustan criteria...
July 2016: Indian Journal of Endocrinology and Metabolism
Rochan Agha-Jaffar, Nick Oliver, Desmond Johnston, Stephen Robinson
The overall incidence of gestational diabetes mellitus (GDM) is increasing worldwide. Preventing pathological hyperglycaemia during pregnancy could have several benefits: a reduction in the immediate adverse outcomes during pregnancy, a reduced risk of long-term sequelae and a decrease in the economic burden to healthcare systems. In this Review we examine the evidence supporting lifestyle modification strategies in women with and without risk factors for GDM, and the efficacy of dietary supplementation and pharmacological approaches to prevent this disease...
September 2016: Nature Reviews. Endocrinology
Mustafa Sahin, Demet Corapcioglu
No abstract text is available yet for this article.
June 23, 2016: New England Journal of Medicine
Fatima C Stanford, Nasreen Alfaris, Madhusmita Misra
No abstract text is available yet for this article.
June 23, 2016: New England Journal of Medicine
Jyoti Balani, Steve Hyer, Hassan Shehata
No abstract text is available yet for this article.
June 23, 2016: New England Journal of Medicine
Rachel T McGrath, Sarah J Glastras, Samantha Hocking, Gregory R Fulcher
The use of metformin in gestational diabetes is safe and effective, yet some women require additional insulin therapy to achieve glycaemic targets. We found a significant association between earlier gestational age at initiation of metformin therapy and the necessity for supplemental insulin in women treated with metformin during pregnancy.
June 2016: Diabetes Research and Clinical Practice
M A Kennelly, F M McAuliffe
A diagnosis of Gestational Diabetes (GDM) confers adverse risk to the health of the mother and fetus both in pregnancy and later life. The background rate in pregnancy varies between 2 and 14% with incidences reported to be as high as 40% in obese populations. GDM diagnoses are escalating because of rising numbers of overweight and obesity in the reproductive age group but also because of different screening and diagnostic criteria. Lifestyle modification in those diagnosed with GDM has been proven to be an effective treatment in attenuating the metabolic dysregulation associated with this and potentially avoiding the need for medical therapy with either metformin or insulin...
July 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
A Zawiejska, E Wender-Ozegowska, K Grewling-Szmit, M Brazert, J Brazert
Gestational diabetes mellitus (GDM) is associated with an increased prevalence of fetal and maternal complications primarily caused by maternal hyperglycemia, which results in abnormal fetal growth. Diet modification is a common first step in the treatment of GDM, followed by antidiabetic pharmacotherapy if this approach fails. Insulin therapy is generally accepted; however, oral hypoglycemic agents have been used in this population. In this prospective, randomised study, we compared maternal metabolic status after treatment with insulin or metformin...
April 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
Rachel A Charlton, Kari Klungsøyr, Amanda J Neville, Sue Jordan, Anna Pierini, Lolkje T W de Jong-van den Berg, H Jens Bos, Aurora Puccini, Anders Engeland, Rosa Gini, Gareth Davies, Daniel Thayer, Anne V Hansen, Margery Morgan, Hao Wang, Anita McGrogan, Anne-Marie Nybo Andersen, Helen Dolk, Ester Garne
AIM: To explore antidiabetic medicine prescribing to women before, during and after pregnancy in different regions of Europe. METHODS: A common protocol was implemented across seven databases in Denmark, Norway, The Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the rest of the UK. Women with a pregnancy starting and ending between 2004 and 2010, (Denmark, 2004-2009; Norway, 2005-2010; Emilia Romagna, 2008-2010), which ended in a live or stillbirth, were identified...
2016: PloS One
Vikram Sinai Talaulikar, Thomas Tang, Ephia Yasmin
IMPORTANCE: Metformin, an oral antihyperglycemic drug, acts as an insulin sensitizer in the treatment of type 2 diabetes mellitus. It has also been widely used in the treatment of polycystic ovary syndrome (PCOS) and gestational diabetes mellitus. Although randomized clinical trials have failed to establish its superiority over other forms of treatment, metformin continues to be a treatment option in specific subgroups of women either alone or as an adjunct with other therapies in management of PCOS...
May 2016: Obstetrical & Gynecological Survey
Shelley Jayne Thorkelson, Kristi R Anderson
IN BRIEF The oral agents glyburide and metformin are both recommended by many professional societies for the treatment of gestational diabetes mellitus (GDM). Both therapeutic modalities have published safety and efficacy data, but there remains much debate among experts. Providers need a clear treatment plan for GDM based on a predictable level of clinical success in obtaining treatment goals. The proper selection of ideal candidates is paramount in achieving clinical success with the use of these medications in the treatment of GDM...
May 2016: Diabetes Spectrum: a Publication of the American Diabetes Association
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