Introduction

1. Effectiveness Of Metformin Versus Insulin For Treating Diabetes In Pregnancy – A Retrospective Cohort Study To Compare Maternal And Perinatal Outcomes Farzeen K. Hashmi, Ayesha Malik, Lumaan Sheikh, Humera Ismail The Aga Khan University, Karachi, Pakistan Methods Results Introduction Conclusions • From our data of 110 patients, 53 had received metformin and 56 patients received insulin as the first line drug of treatment for GDM • The mean birth weight was similar in both the groups, i.e. 2.9 kg in the metformin group and 2.88 kg in the insulin group • Frequency of SGA was comparable; 5.7% in the metformin group and 9.3% in the insulin group • A higher percentage of women in the insulin group developed gestational hypertension, 22.2% vs. 13.7%, though, it did not reach statistical significance (p value=0.31) • One neonate in the metformin group developed respiratory distress syndrome versus none in the insulin group • 7.8% of neonates in the metformin group and 3.6% in the insulin group were shifted to NICU (p value=0.42) • Diabetes complicates nearly 4% of pregnancies in the Pakistani population • Metformin is increasingly being used to treat gestational diabetes mellitus (GDM) in our population either alone or in combination with insulin. • The numbers of studies reporting on metformin use in GDM are still few; most are prospective and from the western world. • Objective of our study: • - To compare the use of metformin with insulin for treating GDM in an urban Pakistani population. • A retrospective cohort • Women with singleton pregnancies diagnosed as GDM who were booked at the AKUH from January 2009 to June 2010 were included • Maternal and neonatal outcomes and complications were assessed for women being treated with metformin and those being treated with insulin • Metformin is as effective as insulin in the treatment of diabetes in pregnancy • Its additional advantages over insulin in terms of convenience in administration as well as reduced cost make it a worthwhile option to explore for use in pregnancy Ball-and-stick model of the metformin molecule, C4H11N5* *Wikipedia References • Rowan, J.A., et al., Metformin versus insulin for the treatment of gestational diabetes. N Engl J Med, 2008. 358(19): p. 2003-15. • Homko, C.J. and E.A. Reece, Insulins and oral hypoglycemic agents in pregnancy. J Matern Fetal Neonatal Med, 2006. 19(11): p. 679-86. • Crowther, C.A., et al., Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med, 2005. 352(24): p. 2477-86. • Ahkter, J., et al., Diabetes in pregnancy in Pakistani women: prevalence and complications in an indigenous south Asian community. Diabet Med, 1996. 13(2): p. 189-91.