Metformin and Insulin Therapy in GDM – Comparison of Maternal and Neonatal Complications

Gestational diabetes mellitus (GDM) is very common medical condition of pregnancy, associated with maternal and neonatal adverse outcomes. Studies suggested that maternal and neonatal complications of gestational diabetes mellitus can be reduced by diet and life style modification, treatment with oral hypoglycemic agent and insulin. The present study was performed to compare the maternal and neonatal consequences in gestational diabetes mellitus patients, those treated with metformin with those treated with insulin. Retrospective study was performed including 31 gestational diabetes mellitus patients treated with metformin and 31 gestational diabetes mellitus patients treated with insulin. It was found that there was no difference between metformin treated patients and insulin treated patients regarding maternal outcomes (body mass index, pregnancy induced hypertension, preeclampsia, candidiasis etc.). Cesarean deliveries were significantly higher in metformin treated group than in insulin group (p<0.05). Forty eight percent GDM patients treated with metformin group underwent cesarean section. The frequency of full term live birth was higher in insulin group than in metformin group (p<0.001). Fifty five percent patients treated with metformin stay at hospital more than 24 hours. There was no difference between the groups in other neonatal outcomes (preterm live birth, macrosomia, still birth, miscarriage, respiratory distress syndrome etc.). The only incidence of neonatal hypoglycemia was higher in insulin group. The data of present retrospective study suggests that there was no major difference in maternal and neonatal outcomes in metformin and insulin treated GDM patients, both drugs showed good glycemic control in GDM patients which resulted in reduction of maternal and perinatal complications, furthermore insulin was not associated with the higher incidence of cesarean section, post natal stay at hospital and preterm live birth compare with metformin.