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We applaud Dr. Rowan and the MiG TOFU (Metformin in Gestational diabetes: The Offspring Follow-Up) investigators for their intense efforts at following the 2-year offspring outcomes from the MiG trial (1). Understanding how in utero exposures impact longer-term offspring consequences is critical. However, we feel compelled to caution against overinterpretation of this study's findings.Of note, 46% of the mothers in the metformin group required insulin to achieve adequate glycemic control (1); therefore, ∼50% in this group actually received both. Although 43% of the total infant cohort received anthropometric measures at 2 years, only ∼15% received dual-energy X-ray absorptiometry (DEXA) scans, thus potentially biasing the results. The absence of any differences in the …

diabetes care

Response to Comments on: Rowan et al. Metformin in Gestational Diabetes: The Offspring Follow-Up (MiG TOFU): Body Composition at 2 Years of Age. Diabetes Care 2011;34:2279–2284