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Metformin during pregnancy safer than insulin : Study


Metformin during pregnancy safer than insulin : Study

Dr. A.Alquadah of  Queen’s University Belfast, Belfast, UK, and associates conducted a  Systematic Review or Meta-analysis to evaluate the risk of pre-eclampsia in high-risk insulin-resistant women taking metformin prior to, or during pregnancy.The researchers found that Metformin was associated with lower gestational weight gain and a lower risk of pre-eclampsia compared with insulin. This implies that Metformin during pregnancy may be safer than insulin.The findings of their research have been published in Diabetic Medicine.

The researchers conducted a search of the Medline, EMBASE, Web of Science and Scopus databases. Both randomized controlled trials and prospective observational cohort studies of metformin treatment vs. placebo/control or insulin either prior to or during pregnancy were selected. The main outcome measure was the incidence of pre-eclampsia in each treatment group.

Overall, in five randomized controlled trials comparing metformin treatment (= 611) with placebo/control (= 609), no difference in the risk of pre-eclampsia was found [combined/pooled risk ratio (RR), 0.86 (95% CI 0.33–2.26); = 0.76; I2 = 66%]. Meta-analysis of four cohort studies again showed no significant effect [RR, 1.21 (95% CI 0.56–2.61); = 0.62; I2 = 30%]. A meta-analysis of eight randomized controlled trials comparing metformin (= 838) with insulin (= 836), however, showed a reduced risk of pre-eclampsia with metformin [RR, 0.68 (95% CI 0.48–0.95); = 0.02; I2 = 0%]. No heterogeneity was present in the metformin vs. insulin analysis of randomized controlled trials, whereas high levels of heterogeneity were present in studies comparing metformin with placebo/control. Pre-eclampsia was a secondary outcome in most of the studies. The mean weight gain from time of enrolment to delivery was lower in the metformin group (= 0.05, metformin vs. placebo; = 0.004, metformin vs. insulin).

It was concluded that in studies randomizing pregnant women to glucose-lowering therapy, metformin was associated with lower gestational weight gain and a lower risk of pre-eclampsia compared with insulin.

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Dr. Kamal Kant Kohli

Dr. Kamal Kant Kohli

A Medical practitioner with a flair for writing medical articles, Dr Kamal Kant Kohli joined Medical Dialogues as an Editor-in-Chief for the Speciality Medical Dialogues. Before Joining Medical Dialogues, he has served as the Hony. Secretary of the Delhi Medical Association as well as the chairman of Anti-Quackery Committee in Delhi and worked with other Medical Councils of India. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751
Source: self

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