Abd El Tawwab A E, Mahmoud M S, El-Kady H A, Elashiry A A, Elsayed H G, Seifelnasr M F
Department of Obstetrics & Gynecology Faculty of medicine, Fayoum university, Fayoum, Egypt.
Department of Pediatrics Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Clin Ter. 2025 Mar-Apr;176(2):148-149. doi: 10.7417/CT.2025.5197.
Although metformin can cross the placenta, its utility in treating gestational diabetes mellitus (GDM) is still debatable.
The purpose of this study was to assess how metformin and insulin affect the outcomes for mothers and newborns in GDM patients.
200 individuals with gestational diabetes who were enrolled in the outpatient clinic at Fayoum University Hospitals (obstetrics and gynecology clinic and family medicine clinic) between March 2024 and August 2024 were the subjects of this randomized controlled research. Patients who satisfied the inclusion and exclusion criteria were randomized to receive either insulin or metformin therapy groups. Blood glucose levels were measured both at enrollment and follow-up appointments. Both maternal and fetal outcomes were the results.
Fasting blood sugar, glycated hemoglobin and 2 hours' postprandial blood sugar did not show significant differences (P >0.05) between the two groups. Additionally, Metformin was beneficial in reducing neonatal birth weight. Also, neonates in the metformin-treated group suffered fewer rates of neonatal hypoglycemia and NICU admission. Maternal hypoglycemia was lower in the metformin group, and patient compliance was higher in the same group (P <0.05).
We may draw the following conclusions from the current study's results that oral metformin was just as effective in managing and controlling gestational diabetes mellitus as insulin injection. Oral metformin was more effective at controlling maternal and fetal hypoglycemia and neonatal birth weight than insulin injection. Complications for mothers and newborns were similar for both treatment modalities. Moreover, treatment with metformin was more complied with by women.
尽管二甲双胍可穿过胎盘，但其在治疗妊娠期糖尿病（GDM）中的效用仍存在争议。
本研究旨在评估二甲双胍和胰岛素对GDM患者母婴结局的影响。
本随机对照研究的对象为2024年3月至2024年8月在法尤姆大学医院门诊（妇产科门诊和家庭医学门诊）登记的200例妊娠期糖尿病患者。符合纳入和排除标准的患者被随机分为接受胰岛素或二甲双胍治疗组。在入组时和随访预约时测量血糖水平。结果包括母婴结局。
两组间空腹血糖、糖化血红蛋白和餐后2小时血糖无显著差异（P>0.05）。此外，二甲双胍有助于降低新生儿出生体重。而且，二甲双胍治疗组的新生儿低血糖发生率和入住新生儿重症监护病房的比例较低。二甲双胍组的母体低血糖发生率较低，且该组患者的依从性较高（P<0.05）。
从本研究结果中我们可以得出以下结论：口服二甲双胍在管理和控制妊娠期糖尿病方面与胰岛素注射同样有效。口服二甲双胍在控制母体和胎儿低血糖及新生儿出生体重方面比胰岛素注射更有效。两种治疗方式的母婴并发症相似。此外，女性对二甲双胍治疗的依从性更高。
