Metformin versus Insulin in Gestational Diabetes Mellitus and its Effect on Prevention of Macrosomia in Fetus
DOI:
https://doi.org/10.70749/ijbr.v3i7.2741Keywords:
Diabetes mellitus, insulin, macrosomia, metformin, pregnancyAbstract
Introduction: Since insulin and metformin are the two most commonly used medications for gestational diabetes mellitus in our nation, it is still up for debate which is the safest and causes less fetal issues. Some professional associations, like the American Diabetes Association, still view insulin as the first line of treatment for GDM. The safety of metformin medication for expectant mothers and their fetuses must thus be regularly assessed. This study aims to assess the incidence of macrosomia in gestational diabetes mellitus between insulin and metformin usage. Materials & Methods: Total 224 pregnant women aged 16–40 years, with singleton pregnancy and gestational diabetes mellitus were included. Women with uncontrolled blood sugar, pregestational diabetes or overt diabetes, multiple pregnancies, babies with known chromosomal abnormalities or severe congenital defects incompatible with life, fetuses with growth restriction, mothers with co-morbid conditions such as severe pre-eclampsia, SLE, chronic hypertension, preterm labor, and premature rupture of membranes were all excluded. Patients in group A received frequent subcutaneous insulin injections, while patients in group B received oral metformin 500 mg tablets. Following then, patients were monitored every two weeks until delivery, at which point macrosomia (yes/no) was recorded. Results: Mean age was 27.53 ± 4.31 years. The average age of the women in groups A and B was 27.40 ± 3.99 and 27.60 ± 5.16 years, respectively. Group A and Group B had mean gestational ages of 36.37 ± 1.40 weeks and 35.57 ± 1.38 weeks, respectively. 3.29 ± 1.17 was the mean parity. In this study, macrosomia was observed in 23 (20.54%) women in group A (insulin) and 09 (8.04%) women in group B (metformin), with a p-value of 0.007. Conclusion: According to this study, using metformin instead of insulin during gestational diabetes mellitus reduces the frequency of macrosomia.
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