Prevention of gestational diabetes by metformin plus diet in patients with polycystic ovary syndrome.

Abstract

OBJECTIVE:

To prospectively assess whether metformin diet safely provides primary and secondary prevention of gestational diabetes (GD).

DESIGN:

Assess development of GD on metformin diet.

SETTING:

Outpatient clinical research center.

PATIENT(S):

One hundred forty-two nondiabetic women with polycystic ovary syndrome (PCOS) who had at least one live-birth (LB) pregnancy on metformin diet (172 pregnancies, 180 LBs).

INTERVENTION(S):

Women were given 26% protein, 44% carbohydrate diets, without calorie restriction during pregnancy. Metformin (2-2.55 g/d) was given preconception, through pregnancy.

MAIN OUTCOME MEASURE(S):

Development of GD.

RESULT(S):

On metformin, GD developed in 12 (7%) of 172 LB pregnancies. Forty-seven women had at least one previous LB pregnancy (n = 64) without metformin, with GD developing in 19 (30%). Subsequently, on metformin, these 47 women had 50 LB pregnancies, developing GD in 6 (12%), which was a statistically significant difference. Of 15 women who had previous GD without metformin, GD developed in 5 (31%) of 16 subsequent pregnancies on metformin. Of 32 women who were previously free of GD without metformin, GD developed in 1 (3%) of 34 subsequent pregnancies on metformin. Previous GD without metformin was the only statistically significant explanatory variable for current GD on metformin.

CONCLUSION(S):

Metformin diet during pregnancy in women with PCOS facilitates primary and secondary prevention of GD.

• Authors: Charles J Glueck, Joel Pranikoff, Dawit Aregawi, Ping Wang
• Journal: Fertility and sterility (Fertil Steril) Vol. 89 Issue 3 Pg. 625-34 (Mar 2008) ISSN: 1556-5653 [Electronic] United States
• PMID: 17678910 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Hypoglycemic Agents
• Insulin
• Metformin

Topics

• Adult
• Blood Glucose (drug effects)
• Body Weight (drug effects)
• Diabetes, Gestational (blood, etiology, prevention & control)
• Female
• Humans
• Hypoglycemic Agents (adverse effects, therapeutic use)
• Insulin (blood)
• Insulin Resistance
• Logistic Models
• Metformin (adverse effects, therapeutic use)
• Odds Ratio
• Phenotype
• Polycystic Ovary Syndrome (blood, complications, diagnosis, diet therapy, drug therapy, therapy)
• Pregnancy
• Pregnancy Outcome
• Prospective Studies
• Risk Assessment
• Risk Factors
• Treatment Outcome