Efficacy and Safety of Metformin in Gestational Diabetes Mellitus

2020 ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Age ◽  
Metabolic Effects ◽  
Control Group ◽  
Minimal Risk ◽  
Insulin Group ◽  
Diet Control

Background: Gestational Diabetes Mellitus (GDM) is a sequence of serious unfavorable maternal and perinatal outcomes specially if uncontrolled. Although insulin is a standard therapy, Metformin can be used as an alternative medication to insulin. This study aimed to establish the efficacy, safety, and other metabolic effects of metformin in GDM due to limited studies in the local population. Methods: This quasi experimental trial was conducted on pregnant female at 24 weeks of gestation and above, presenting to Ziauddin Hospital. A total of 361 patients who were diagnosed with GDM were enrolled. Patients were divided into three groups: diet control, metformin, and metformin with insulin. The Chi Square and ANOVA were used to compare the maternal and neonatal outcomes. Further post hoc analysis of significant parameters was done using Tukey HSD test. Results: Weight gain in pregnancy and gestational age at delivery gives significant mean differences across three study groups (p=<0.01). In diet control group, weight was significantly gained as compare to metformin group. Similarly, the gestational age in diet control group was significantly higher as compare to metformin and metformin with insulin group (p=<0.01). The higher gestational age was found in patients treated with metformin as compared to metformin with insulin group (37.25±1.41). Conclusion: Metformin alone as well as in combination with insulin, is a safe, effective treatment option and more acceptable to women with GDM. Metformin has shown to cause less weight gain during pregnancy with minimal risk of maternal and neonatal hypoglycemia. Keywords: Gestational Diabetes Mellitus; Metformin; Insulin

scholarly journals Management of postprandial hyperglycaemia and weight gain in women with gestational diabetes mellitus using a novel telemonitoring system

2018 ◽  
Vol 47 (2) ◽  
pp. 754-764 ◽  
Author(s):  
Ebtisam A. Al-ofi ◽  
Hala H. Mosli ◽  
Kholoud A. Ghamri ◽  
Sarah M. Ghazali
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Dietary Advice ◽  
Control Group ◽  
Close Monitoring ◽  
Pregnancy Weight Gain ◽  
Glucose Levels ◽  
Pregnancy Weight

Objectives The purpose of this study was to investigate the effect of remotely delivered telemedicine dietary advice on monitoring of blood glucose levels and weight gain of women with gestational diabetes mellitus (GDM). Methods Women with GDM were recruited and randomly allocated into two groups: a Tele-GDM group that received a telemonitoring device, and a control group that was followed-up traditionally. A telemonitoring service calculated the ratio of reaching or exceeding the pregnancy weight gain target (according to pre-pregnancy weight), following Institute of Medicine guidelines for healthy pregnancy weight gain. Results The sample comprised 27 women in the Tele-GDM group and 30 in the control group. At the end of pregnancy, the Tele-GDM group showed significantly lower 2-hour postprandial glucose levels than the control group. Most women in the Tele-GDM group reached their recommended range of weight gain at the end of pregnancy. Additionally, the Tele-GDM group showed significantly lower weight gain than the control group. Conclusions Telemonitoring can facilitate close monitoring of women with GDM and motivate patients to adopt a healthy lifestyle.

THE ASSOCIATION OF GESTATIONAL WEIGHT GAIN AND ADVERSE PREGNANCY OUTCOMES IN WOMEN WITH GESTATIONAL DIABETES MELLITUS

2019 ◽  
Vol 25 (11) ◽  
pp. 1137-1150 ◽  
Author(s):  
Qianyue Xu ◽  
Zhijuan Ge ◽  
Jun Hu ◽  
Shanmei Shen ◽  
Yan Bi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Large For Gestational Age ◽  
Institute Of Medicine ◽  
Gestational Weight

Objective: To explore the association of excessive gestational weight gain (GWG) defined by the Institute of Medicine (IOM) targets and adverse perinatal outcomes in gestational diabetes mellitus (GDM) pregnancies, and whether a modified target might be related to a lower rate of adverse perinatal outcomes for GDM. Methods: This retrospective cohort study involved 1,138 women of normal glucose tolerance (NGT) and 1,200 women with GDM. Based on the IOM target, pregnancies were classified to appropriate GWG (aGWG), inadequate GWG, and excessive GWG (eGWG). Modified GWG targets included: upper limit of IOM target minus 1 kg (IOM-1) or 2 kg (IOM-2), both upper and lower targets minus 1 kg (IOM-1-1) or 2 kg (IOM-2-2). Results: The proportions of women achieving eGWG were 26.3% in NGT and 31.2% in GDM ( P = .036); in comparison, for aGWG NGT, the risks of large for gestational age (LGA) were significantly higher in eGWG NGT (adjusted odds ratio [OR] 1.47; 95% confidence interval [CI] 1.02 to 2.13), aGWG GDM (adjusted OR 1.42; 95% CI 1.03 to 1.95), and eGWG GDM (adjusted OR 2.70; 95% CI 1.92 to 3.70). GDM pregnancies gaining aGWG based on the modified GWG targets (IOM-2, IOM-1-1, and IOM-2-2) had a lower prevalence of LGA and macrosomia delivery than that for similar pregnancies using the original IOM target (all P<.05). Conclusion: For aGWG GDM according to the IOM target, adhering to a more stringent weight control was associated with decreased adverse outcomes. A tighter IOM target might help to reduce the prevalence of adverse pregnancy outcomes. Abbreviations: aGWG = appropriate gestational weight gain; BG = blood glucose; BMI = body mass index; CI = confidence interval; eGWG = excessive gestational weight gain; GDM = gestational diabetes mellitus; GW = gestational weeks; GWG = gestational weight gain; HbA1c = hemoglobin A1c; iGWG = inadequate gestational weight gain; IOM = Institute of Medicine; LGA = large for gestational age; NGT = normal glucose tolerance; NICU = neonatal intensive care unit; OGTT = oral glucose tolerance test; OR = odds ratio; PARp = partial population attributable risks; SGA = small for gestational age

scholarly journals GESTATIONAL DIABETES MELLITUS;

2019 ◽  
Vol 26 (01) ◽  
Author(s):  
Khiaynat Sarwar Hashmi ◽  
Tasneem Akhtar ◽  
Sidrah Batool ◽  
Kokab Saleem
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Blood Sugar ◽  
Neonatal Outcome ◽  
Regular Insulin ◽  
Insulin Group ◽  
Metformin Group ◽  
Number Of Patients

Objectives: To Compare metformin and regular insulin in blood sugar control and neonatal outcome in patients with gestational diabetes mellitus. Material and Method:… Study Design:  Randomized control trial. Place of the Study: Department of Gynecology and Obstetrics, Bahawal Victoria hospital Bahawalpur. Duration of the study.1 year 1st January 2017- 31st December 2017. Sample Size: N=200, one half (group A) receiving Metformin and other half (group B) receiving regular insulin. Results: Blood sugar control depicted by fasting, 2 hr post parandial levels and HbA1c % was similar in both group.coexisting hypertensive complications were seen more in insulin group. Weight gain was also significantly more in insulin group 17 kg on an average as compared to metformin group where average weight gain was 13 kg.Convenience and satisfaction regarding their treatment,more number of patients were satisfied in metformin group. There were significant increase in the mean birth weight of the newborns, need for admission in NICU and Neonatal hypoglycemia in insulin group as compared to metformin group. Conclusion: Metformin when compared to insulin has equal efficacy in controlling maternal blood sugar levels but better neonatal outcome, patient satisfaction and convenience in treatment of gestational Diabetes Mellitus.

Thyroid Dysfunction in Pregnant Women with Gestational Diabetes Mellitus

2020 ◽  
Vol 16 (8) ◽  
pp. 895-899 ◽  
Author(s):  
Shahin Safian ◽  
Farzaneh Esna-Ashari ◽  
Shiva Borzouei
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Control Group ◽  
Thyroid Peroxidase ◽  
Free T4 ◽  
Significant Difference ◽  
Experimental Group

Aims: Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Method: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Result: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.

scholarly journals Associations between gestational diabetes mellitus and the neurodevelopment of offspring from 1 month to 72 months: study protocol for a cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040305
Author(s):  
Chao Li ◽  
Ping Zhou ◽  
Yixi Cai ◽  
Bin Peng ◽  
Yongfang Liu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Public Health Problem ◽  
Multiple Linear Regression Model ◽  
Preschool Age ◽  
Control Group ◽  
Global Public Health ◽  
Open Access Journals

IntroductionGestational diabetes mellitus (GDM) is a common gestational disease and an important global public health problem. GDM may affect the short-term and long-term health of offspring, but the associations between GDM and the neurodevelopment of offspring of mothers with GDM (OGDM) are still unclear, and studies based on the Chinese population are lacking. We aim to determine the associations between GDM and the neurodevelopment of OGDM by studying a cohort of OGDM and offspring of non-GDM mothers.Methods and analysisThe single-centre prospective cohort study is being conducted in China over 7 years. A total of 490 OGDM (GDM group) and 490 fromof healthy mothers (control group) will be enrolled during the same period. Baseline characteristics, neuropsychological development scores and clinical data at specific time points (at 0, 1, 3, 6, 12, 24, 36, 48, 60 and 72 months old) will be collected from the children in both groups until the age of 6 years. The associations between GDM and the neurodevelopment of OGDM from infancy to preschool age will be analysed using a multiple linear regression model adjusted for confounders. In addition, we will compare longitudinal data to further assess the effects of GDM on neurodevelopmental trajectories.Ethics and disseminationThe study has been approved by the Ethics Committee of the Children’s Hospital of Chongqing Medical University (Approval Number: (2019) Institutional Review Board (IRB) (STUDY) No. 85). The findings of this study will be disseminated through open access journals, peer-reviewed journals and scientific meetings.Trial registration numberNCT03997396.

445: The relationship between gestational weight gain and gestational diabetes mellitus

2015 ◽  
Vol 212 (1) ◽  
pp. S229
Author(s):  
Amy O'Higgins ◽  
Lisa O'Higgins ◽  
Anne Fennessy ◽  
Thomas McCartan ◽  
Laura Mullaney ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Weight Gain ◽  
Gestational Weight ◽  
The Relationship
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