Main Article Content
Objective: To determine the effectiveness of metformin vs insulin for glycemic control in gestational diabetes mellitus.
Methodology: This study was done in the Department of Gynecology and Obstetrics, Saidu Teaching Hospital Swat from November 2019 to May 2020. Ethical approval was taken from the hospital ethical and research committee. A sample of 93 patients in each group was taken as per WHO sample size calculation software. All female patients with singleton pregnancies having gestational diabetes diagnosed for the first time in current pregnancy with an age limit from 16-40 Years were included in this study. The lottery method was used for dividing patients into two groups, group A (Metformin) and group B (Insulin). SPSS 23.0 was used for the data analysis using frequencies and percentages and the Chi-Square test was used to compare the efficacy of drugs between the two study groups. Efficacy was checked by measuring 1-hour postprandial sugar levels, i-e; more or less than 140mg/ dl. A p-value less than or equal to 0.05 was considered statistically significant.
Results: Total number of patients was 186 (93 in each group). The mean age in group A was 28±3.76 years compared to 27±3.13 years in group B. Good glycemic control out of our total 186 patients (93 in each group) was achieved in 80%(n-74) in Group A compared to 90% (n-84) in Group B with a p-value was 0.0403.
Conclusion: The study concludes that metformin is non-inferior to insulin in controlling glucose levels in gestational diabetes mellitus.
Work published in JPMI is licensed under a
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
Tripathi R, Tyagi S, Goel V. Metformin in gestational diabetes mellitus. Indi¬an J Med Res. 2017;145(5):588-91. DOI:10.4103/ijmr.IJMR-1572-16.
Saleh HS, Abdelsalam WA, Mowafy HE, Abd ElHameid AA. Could Met¬formin Manage Gestational Diabetes Mellitus instead of Insulin? Int J Reprod Med. 2016;2016:3480629. DOI: 10.1155/2016/3480629.
Mahmood OA. Metformin versus in¬sulin in the management of gestation¬al diabetes mellitus. Med J Babylon. 2019;16(4):346-50. DOI. 10.4103/ MJBL.MJBL_11_19
Hamadani A, Zahid S, Butt ZB. Met¬formin versus Insulin Treatment in Gestational Diabetes in Pregnancy and Their Effects on Neonatal Birthweight. Pak J Med Health Sci. 2017;11(3):914- 6.
Gray SG, McGuire TM, Cohen N, Little PJ. The emerging role of metformin in gestational diabetes mellitus. Diabetes Obes Metab. 2017;19(6):765-772. DOI:10.1111/dom.12893.
Soliman M, Abdel Hamid A, Abd El- Gayed A, Saif-Elnasr I. Comparing the efficacy and safety between Insulin and Metformin in gestational diabetes mellitus management. Menoufia M J. 2019;32(4):1376-81. DOI: 10.4103/ mmj.mmj_303_18.
Juan G, Qing L, Ling F. Metformin vs In¬sulin in the Management of Gestational Diabetes: A Meta-Analysis. PLoS One. 2013;8(5): e64585. DOI: 10.1371/ journal.pone.0064585
Spaulonci CP, Bernardes LS, Trindade¬TC. Randomized trial of metformin vs insulin in the management of gesta¬tional diabetes. Am J Obstet Gynecol. 2013; 209:34. 1-7. DOI: 10.1016/j. ajog.2013.03.022.
Shaheen S, Ali R, Afzal U. Gestational diabetes: Accuracy of glucose chal¬lenge test (GCT) for screening. Pro¬fessional Med J. 2013;20(2):232-6. DOI:10.29309/TPMJ/2013.20.02.632.
Tertti K, Ekblad U, Vahlberg T, Rönne¬maa T. Comparison of metformin and insulin in the treatment of gestational diabetes: A retrospective, case control study. Rev Diabet Stud. 2008;5(2):95- 101. DOI:10.1900/RDS.2008.5.95.
Cheung NW. The management of gesta¬tional diabetes. Vasc Health Risk Manag. 2009;5(1):153-64. DOI:10.2147/vhrm. s3405.
Fraser R, Farrell T. Diabetes. In: James, Steer, Weiner, Growther G, Robson, ed¬itors. High risk pregnancy management options. 4th ed. UK: Elsevier Saunders. 2011. p.795-811.
Rowan JA, Hague WM, Gao W, Battin MR, Moore MP. Metformin versus insulin for the treatment of gestational diabe¬tes. N Engl J Med. 2008;358(19):2003- 15. DOI:10.1056/NEJMoa0707193.
Ali S N, Dornhorst A.Diabetes and en¬docrine disease in pregnancy. In: Ed¬monds DK, editor. Dewhurts textbook of obstetrics and Gynecology. 9th ed. UK: Blackwell Publishing Ltd; 2018. p. 99-100.
Jang HC, Cho HC, MinYK. Increased macrosomia and perinatal morbidity independent of materal obesity and ad¬vnced age in Korean women with GDM. Diabetes Care. 1997; 20:1582-88. DOI:10.2337/diacare.20.10.1582
Waheed S, Malik FP, Mazhar SB. Effi¬cacy of Metformin Versus Insulin in the Management of Pregnancy with Diabetes. J Coll Physicians Surg Pak. 2013;23(12):866-9.