Comparison of maternal and perinatal outcome among patients with gestational diabetes treated with either metformin or insulin – an observational prospective cohort study

Abstract

Introduction: Insulin therapy is the current gold standard in the treatment of gestational diabetes. Safe and effective oral therapy would be more acceptable to the pregnant population. We did this study to compare the maternal and fetal outcomes among patients treated with insulin and metformin in gestational diabetes.

Materials and Methods: We did an observational prospective cohort study on 123 consecutive patients diagnosed to have gestational diabetes. Patients included in the study were followed up for the rest of the antenatal period, during labour and for 6 weeks after delivery for maternal and perinatal outcomes.

Results: There was no significant difference between the two groups in respect to all the maternal and perinatal outcomes studied. Among the 61 patients in the metformin group 55 (90%) attained glycemic target with metformin alone while 6(10%) had to be given insulin along with metformin.

Conclusion: Metformin appears to be an effective treatment for gestational diabetes. Metformin is more acceptable to women due to its ease of administration and lower cost as compared to insulin. A drawback which is observed with the use of metformin is the inability of metformin therapy alone to achieve good glycemic control and thereby leading to adverse consequences in the fetus.