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NEW YORK (Reuters Health) - Use of metformin to treat pregnancy-related diabetes (i.e., gestational diabetes) does not increase the risk of pregnancy complications and most women prefer it to insulin, according to a study in this week's New England Journal of Medicine.
Metformin, sold under various trade names such as Glucophage, is primarily used to lower blood sugar in patients with type 2 diabetes.
Theoretically, metformin is a logical treatment for gestational diabetes, as it improves how the body responds to insulin and does not cause weight gain or low blood sugar, Dr. Janet A. Rowan, from Auckland City Hospital in New Zealand, and colleagues note. Its use in pregnant women, however, is controversial since one study tied the drug to fetal loss and preeclampsia, a dangerous condition in which a woman's blood pressure spikes during pregnancy.
To investigate further, Rowan's team randomly assigned 751 women with gestational diabetes who were 20 to 33 weeks pregnant to metformin or insulin. Supplemental insulin was given to metformin users if needed.
According to the researchers, the rate of the composite outcome - that is, low blood sugar, respiratory distress, need for phototherapy, birth trauma, low Apgar score and prematurity -- was nearly the same in each group (32 percent in the metformin group and 32 percent in the insulin group).
Metformin was not associated with any serious side effects and, overall, roughly 77 percent of women treated with metformin said they would prefer to receive it again if needed, compared with just 28 percent of insulin-treated women who said they would prefer to receive insulin again.
"The take home message, we believe, is that metformin is an appropriate alternative to insulin treatment for women with gestational diabetes who require additional therapy (beyond lifestyle intervention)," Rowan concluded.
SOURCE: The New England Journal of Medicine, May 8, 2008.
