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Metformin as a prophylactic treatment of gestational diabetes in pregnant patients with pregestational insulin resistance: A randomized study
Author(s) -
Valdés Enrique,
SepúlvedaMartínez Alvaro,
Candia Paula,
Abusada Nancy,
Orellana Rodrigo,
Manukian Bárbara,
Cuellar Eduardo
Publication year - 2018
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13477
Subject(s) - medicine , metformin , placebo , gestational diabetes , insulin resistance , diabetes mellitus , randomized controlled trial , gestation , incidence (geometry) , insulin , pregnancy , obstetrics , endocrinology , alternative medicine , physics , pathology , biology , optics , genetics
Abstract Aim We aimed to assess the use of metformin ( MTF ) in the prevention of gestational diabetes mellitus ( GDM ) in patients with pregestational insulin resistance ( PIR ). Methods A double blind, multicenter, randomized trial was carried out in patients with a history of PIR and pregestational MTF treatment. Groups were allocated either to MTF 1700 mg/day or placebo. Patients were recruited between 12 +0 and 15 +6 gestational weeks, and treatment was extended until week 36. A multiple logistic regression analysis was applied to determine the relation between the use of metformin and the development of GDM . Results One hundred and forty one patients were randomized (68 patients in the MTF group and 73 in the placebo group). A total of 30 patients withdrew from the study during follow‐up. Administration of MTF was not associated with a decrease in the incidence of GDM as compared to placebo (37.5% vs 25.4%, respectively; P = 0.2). Moreover, MTF administration was associated with a significant increase in drug intolerance as compared to placebo (14.3% vs 1.8%, respectively; P = 0.02). Conclusion The use of MTF is not effective in prevention of GDM in populations with PIR . The use of MTF shows a significantly higher frequency of drug intolerance than placebo.