New research presented at the Endocrine Society’s ENDO 24 annual meeting suggests that metformin, an oral medication commonly used to treat type 2 diabetes, may be just as safe as insulin for managing diabetes during pregnancy.
The study, which has yet to be peer-reviewed and published, followed the health outcomes of 10,117 mother-child pairs for up to 11 years after childbirth. Researchers found that using metformin during pregnancy did not lead to any increased risk to the health of the baby or the mother compared to using insulin.
Both metformin and insulin are considered viable options for managing blood glucose levels in pregnant women with type 2 diabetes and gestational diabetes. Despite insulin being the traditional choice due to its inability to cross the placenta, thus posing no direct risk to the fetus, metformin has been prescribed for more than six decades, including during pregnancy.
The study’s lead author, from the Center for Endocrinology, Diabetes, Arthritis & Rheumatism in New Delhi, India, examined various long-term health variables, including body mass index (BMI), waist circumference, and rates of obesity and diabetes in both mothers and children. They found no significant increase in adverse outcomes among children born to mothers who took metformin during pregnancy compared to those who used insulin.
This research is particularly relevant given the rising rates of obesity among women, which increases the risk of developing type 2 diabetes during or after pregnancy. High blood glucose levels during pregnancy are associated with several complications, including an increased risk of cesarean section, macrosomia (overweight babies), and postpartum obesity in the mother.
While metformin offers a simpler dosing regimen and is less likely to cause weight gain compared to insulin, experts emphasize that the choice between the two medications should be based on individual factors beyond the diabetes diagnosis. Lifestyle changes, such as diet and exercise, should also be considered in conjunction with medication.
Metformin primarily works by reducing liver glucose release and increasing insulin sensitivity, while insulin helps cells utilize glucose in the bloodstream. Combining these medications can significantly improve blood glucose levels in pregnant women. However, it’s crucial for women who were previously on insulin not to switch to metformin alone, as insulin may still be necessary to manage blood glucose effectively during pregnancy.
Overall, the study suggests that metformin can be a valuable option for managing diabetes during pregnancy, but decisions should be made on a case-by-case basis in consultation with healthcare professionals. Managing diabetes during pregnancy requires careful monitoring and adjustment, underscoring the importance of personalized care throughout this critical period.
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