Gerede Angeliki, Domali Ekaterini, Chatzakis Christos, Margioula-Siarkou Chrysoula, Petousis Stamatios, Stavros Sofoklis, Nikolettos Konstantinos, Gouveri Evanthia, Sotiriou Sotirios, Tsikouras Panagiotis, Dinas Konstantinos, Nikolettos Nikolaos, Papanas Nikolaos, Goulis Dimitrios G, Sotiriadis Alexandros
Unit of Maternal-Fetal-Medicine, Department of Obstetrics and Gynecology, Medical School, Democritus University of Thrake, 67100 Komotini, Greece.
First Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Life (Basel). 2025 Jan 20;15(1):130. doi: 10.3390/life15010130.
There has been accumulating evidence over the past two decades that metformin can be an effective treatment for gestational diabetes mellitus (GDM) in women whose diet and exercise fail to attain optimal glycemic control. The objective of this review was to comprehensively analyze all studies investigating the effectiveness of metformin compared to insulin and other drugs utilized for the treatment of GDM. After a comprehensive literature review based on PRISMA 2020, 35 studies were included after a selection process utilizing predetermined inclusion and exclusion criteria. A variety of short-term maternal and neonatal outcomes were assessed. Metformin is a highly efficient medication for attaining optimal control of blood sugar levels in women with GDM, resulting in a significant reduction in the amount of weight gained during pregnancy. Regarding additional maternal outcomes, such as pregnancy-induced hypertension and cesarean deliveries, some studies demonstrate a link between metformin and a reduced occurrence of both conditions. In contrast, others do not find an association. Regarding short-term neonatal outcomes, metformin does not exhibit any changes in gestational age at delivery. In contrast, metformin demonstrated substantial decreases in the likelihood of greater gestational birth weight and neonatal hospitalization when compared to other drugs. When compared primarily to insulin, metformin decreases the probability of several short-term outcomes related to pregnancy and newborns. Additional data are necessary for extended follow-up studies, including patients with GDM treated with metformin.
在过去二十年中，越来越多的证据表明，对于饮食和运动未能实现最佳血糖控制的女性，二甲双胍可有效治疗妊娠期糖尿病（GDM）。本综述的目的是全面分析所有研究，比较二甲双胍与用于治疗GDM的胰岛素和其他药物的有效性。基于PRISMA 2020进行全面文献综述后，经过使用预定纳入和排除标准的筛选过程，纳入了35项研究。评估了各种短期母婴结局。二甲双胍是一种高效药物，可实现GDM女性血糖水平的最佳控制，显著减少孕期体重增加量。关于其他母亲结局，如妊娠高血压和剖宫产，一些研究表明二甲双胍与这两种情况发生率降低之间存在联系。相比之下，其他研究未发现关联。关于短期新生儿结局，二甲双胍对分娩时的孕周没有影响。相比之下，与其他药物相比，二甲双胍显著降低了巨大儿出生体重和新生儿住院的可能性。与胰岛素相比，二甲双胍降低了一些与妊娠和新生儿相关的短期结局的概率。对于包括接受二甲双胍治疗的GDM患者在内的长期随访研究，还需要更多数据。
