Open AccessThe effects of metformin treatment of gestational diabetes on maternal weight and glucose tolerance postpartum – a prospective follow‐up study
Author(s) -
Pellonperä Outi,
Rönnemaa Tapani,
Ekblad Ulla,
Vahlberg Tero,
Tertti Kristiina
Publication year - 2016
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12788
Subject(s) - medicine , gestational diabetes , metformin , glycemic , insulin , impaired glucose tolerance , prospective cohort study , diabetes mellitus , endocrinology , weight gain , pregnancy , gestation , obstetrics , randomized controlled trial , glucose tolerance test , insulin resistance , body weight , genetics , biology
Metformin seems to reduce gestational weight gain compared with insulin in women with gestational diabetes ( GDM ). Women with GDM requiring insulin are more likely to develop abnormal glucose tolerance postpartum than women treated with diet only. In this prospective follow‐up study of a randomized clinical trial, we investigated the effect of metformin treatment in women with GDM on weight gain and glucose tolerance postpartum. Materials and Methods Women with GDM with two or more pathologic glucose values at 2‐h 75‐g oral glucose tolerance test ( OGTT ) were recruited. Those needing medication to achieve sufficient glycemic control were randomized at 22–34 weeks of gestation to either metformin ( n = 110) or insulin ( n = 107) treatment until delivery. A third GDM group ( n = 128) requiring no medication had only diet treatment. Weight, OGTT and glycosylated hemoglobin (HbA1c) were determined at 6–8 weeks and 1 year postpartum. Results At least one postpartum visit was attended by 104, 101 and 120 women in the metformin, insulin and diet‐only groups, respectively. No significant differences were found in the change of weight, HbA1c or OGTT glucose values between the groups during the study ( p ≥ 0.121 in all comparisons). One year postpartum the diet‐only group had less impaired glucose tolerance compared with the metformin and insulin groups (7.1%, 19.1% and 15.6%, respectively; overall p = 0.039) and a lower incidence of diabetes ( p = 0.027). Conclusions Short‐term metformin therapy does not affect weight, HbA1c or OGTT glucose values postpartum compared with insulin or diet‐only treatments. Women with GDM requiring no medication are least likely to develop impaired glucose tolerance or diabetes postpartum.