Metformin could be beneficial for gestational diabetes

The use of metformin among pregnant women with gestational diabetes was associated with enhanced glycemic control and reduced gestational weight gain, according to a randomized, placebo-controlled study published in JAMA.

The trial was conducted from June 2017 to September 2022 at two sites in Ireland, comprising 510 women with gestational diabetes.

The patients were randomly assigned to receive either a placebo or metformin with a maximum dose of 2,500 mg. Researchers at the University of Galway in Ireland found that the trial’s primary outcome—a composite of insulin initiation or a fasting glucose of 5.1 mmol/L or higher at gestation weeks 32 or 38—did not differ notably between the two groups.

However, the women who used metformin were significantly less likely to require insulin and had considerably lower fasting blood glucose levels at weeks 32 and 38, the researchers found. There was a nonsignificant increase in small-for-gestational-age babies among those using metformin. The researchers plan to follow up with mother and infant to see if those diagnosed as small for gestational age turn out to have an increase in BMI and weight as they grow into adolescents.