Objective: To determine efficacy of metformin in maintaining euglycemia in patients with GDM among women presenting in our institution.
Methodology: It was a prospective study conducted at the department of Obstetrics & Gynecology Railway teaching Hospital IIMCT, Rawalpindi from October 2014 to April 2015 and included 60 patients of 18-45 years of age at 10-32 weeks gestation in singleton pregnancy with fasting blood glucose levels > 6.1 mmol /L & 2 hours Post Prandial levels > 7.8 mml/L Metformin is started at a dose of 500mg daily and increased up to 2500mg daily. Aim was to keep fasting sugar level between 3.5 – 5.9 mmol/L & 2 hours post prandial < 7.8 mmol/L.
Results: The median daily dose of metformin was 1500 mg. The mean gestational age at delivery was 38.1 weeks. Neonatal hypoglycemia (glucose level < 1.6mmol/L ) was less common. The only adverse effects of metformin was GI upset (13.1 %) The results of postpartum questionnaire assessing acceptability of treatment among women treated with metformin alone, 65.6 % said they would chose metformin in subsequent pregnancy. The efficacy of metformin alone was 85.7%.
Conclusion: In women with gestational diabetes mellitus, metformin (alone or with supplemental insulin) is not associated with increased prenatal complications. The women preferred metformin to insulin treatment.
Metformin, Gestational diabetes, BMI, Insulin