Khadija Bano, Shazia Naseeb, Shereen Zulfiqar Bhutta.
Comparing effectiveness of metformin versus insulin in gestational diabetes mellitus.
Pak J Surg Jan ;31(4):260-4.

Objectives: To determine if metformin compared to Insulin is a safe and eff ective treatment option in the management of gestational diabetes mellitus. Study Design: Randomized open label controlled trial Study Sett ing: Department of gynecology and obstetrics, Ward 9(Unit II), Karachi, Pakistan Duration of study: Six months (11th September 2012 till 10th March 2013) Subject and methods: A total of 134 women with GDM diagnosed on single fasting blood sugar followed by confi rmation by oral glucose tolerance test (OGTT ) were included in the study. Patients were randomly allocated to two groups. 76 patients assigned each to Insulin and Metformin group. Demographic and clinical data were recorded at enrollment followed by OGTT . Informed consent was obtained . Eff ectiveness was seen in terms of maternal hyperglycemia (Fasting blood sugar>- 100mg/dl of Postprandial >-126 mg/dl), Gestational hypertension Blood pressure (BP > 140/90 mg /dl without proteinuria), preeclampsia (BP >- 140/90mg/ dl with proteinuria of > 0.3mg/24 hours), preterm labor (28-less than 37 weeks gestation), polyhydramnios (AFI > 5), and mode of delivery. Neonataloutcome in terms of macrosomia (4000mg), Apgar score at 5 minand hypoglycemia at birth. Results: Eff ectiveness of metformin treatment was 67.7% and insulin 70.1%, the diff erence was not signifi cant (p-value=0.71) Conclusion: We conclude that metformin and Insulin are equally eff ective and metformin is not associated with increased risk of maternal and neonatal complications.

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