Short‐ and long‐term outcomes of metformin compared with insulin alone in pregnancy: a systematic review and meta‐analysis

  title={Short‐ and long‐term outcomes of metformin compared with insulin alone in pregnancy: a systematic review and meta‐analysis},
  author={Sonia Butalia and L Gutierrez and Abhay Lodha and E Aitken and A Zakariasen and Lois E. Donovan},
  journal={Diabetic Medicine},
  pages={27 - 36}
AIM To assess the short- and long-term maternal and fetal impact of metformin in pregnancy compared with insulin. [] Key MethodMETHODS We performed a comprehensive literature search of MEDLINE, EMBASE, BIOSIS, Cochrane Database of Systematic Reviews and

Gestational metformin administration in women with polycystic ovary syndrome: A systematic review and meta‐analysis of randomized control studies

To evaluate metformin's effects on pregnancy outcomes in women with polycystic ovary syndrome, a large number of women diagnosed with the disease have had at least one miscarriage in the past five years.

Metformin for prevention of hypertensive disorders of pregnancy in women with gestational diabetes or obesity: systematic review and meta‐analysis of randomized trials

Whether metformin use is associated with the incidence of hypertensive disorders of pregnancy (HDP) is determined by a systematic review and meta‐analysis of randomized trials.

Effectiveness of antidiabetic agents for treatment of gestational diabetes: A methodological quality assessment of meta‐analyses and network meta‐analysis

Assessment of the methodological quality of available meta‐analyses on the effects of antidiabetic agents in patients with gestational diabetes mellitus and a summary estimation of the effectiveness of treatments modalities.

Real‐world experience of metformin use in pregnancy: Observational data from the Northern Territory Diabetes in Pregnancy Clinical Register

In Australia's Northern Territory, Indigenous mothers account for 33% of births and have high rates of hyperglycemia in pregnancy, and the use of metformin is common.

Changing patterns in medication prescription for gestational diabetes during a time of guideline change in the USA: a cross‐sectional study

To define patterns of prescription and factors associated with choice of pharmacotherapy for gestational diabetes mellitus (GDM), namely metformin, glyburide and insulin, during a period of evolving

Metformin in pregnancy and risk of adverse long-term outcomes: a register-based cohort study

This study found no increased long-term risk associated with pregnancy exposure to metformin (alone or in combination with insulin), compared with insulin, and suggests caution in pregnancies with at-risk fetal undernutrition.

The efficacy and safety of metformin alone or as an add‐on therapy to insulin in pregnancy with GDM or T2DM: A systematic review and meta‐analysis of 21 randomized controlled trials

Metformin may have potential benefits for pregnant women and newborns in terms of maternal and foetal outcomes and more studies with long‐term follow‐up of offspring exposed to metformin in utero are needed to provide evidence for the future use of met formin in pregnancy.

Impact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis

Metformin for any indication during pregnancy is associated with lower GWG and a modest reduced risk of pre-eclampsia, but increased gastrointestinal side-effects compared to other treatments.

In pregnant women with diabetes mellitus, is metformin as effective as insulin in preventing neonatal hypoglycemia?

In pregnant womenwith diabetesmellitus, metformin with or without insulin likely reduces the risk of hypoglycemia in neonates by one-third compared with insulin alone (SOR: B, meta-analysis of



A follow‐up of a randomised study of metformin and insulin in gestational diabetes mellitus: growth and development of the children at the age of 18 months

To compare the growth and development of children born to mothers with gestational diabetes mellitus (GDM) requiring pharmacological treatment, and randomised to treatment with metformin or insulin.

Metformin treatment in pregnant women with polycystic ovary syndrome—is reduced complication rate mediated by changes in the uteroplacental circulation?

  • K. SalvesenE. VankyS. Carlsen
  • Medicine
    Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
  • 2007
To study a possible effect of metformin on the uteroplacental circulation, a large number of animals were slaughtered to study the effects of the drug on the uterus.

Metformin vs. insulin in gestational diabetes. A randomized study characterizing metformin patients needing additional insulin

We compared metformin with insulin as treatment of gestational diabetes mellitus (GDM). Furthermore, we aimed to characterize metformin‐treated patients needing additional insulin to achieve

Metformin should be considered in the treatment of gestational diabetes: a prospective randomised study

The use of metformin in the treatment of gestational diabetes should be considered, according to a prospective randomised study carried out in Finland.

Metformin vs Insulin in the Management of Gestational Diabetes: A Meta-Analysis

A meta-analysis of 5 RCTs comparing the effects of metformin with insulin on glycemic control, maternal and neonatal outcomes in gestational diabetes mellitus (GDM) found that it might be more suitable for women with mild GDM.

Metformin for gestational diabetes in routine clinical practice

Diabet. Med. 28, 1082–1087 (2011)

Effect comparison of metformin with insulin treatment for gestational diabetes: a meta-analysis based on RCTs

Metformin can significantly reduce several adverse maternal and neonatal outcomes including PIH rate, incidence of hypoglycemia and NICU, thus it may be an effective and safe alternative or additional treatment to insulin for GDM women.

Metformin's Effect on First-Year Weight Gain: A Follow-up Study

Women randomized to metformin were heavier in the first trimester, gained less weight in pregnancy, and lost less weightIn the first year postpartum compared with women randomized to placebo, children exposed to met formin weighed more at 1 year of age.

Growth, body composition and metabolic profile of 8-year-old children exposed to metformin in utero

Metformin exposure during fetal life does not seem to influence growth and body composition at the age of 8 years, and a higher fasting glucose level and a possible higher systolic blood pressure and lower LDL cholesterol level in the metformin group may be coincidental.

Metformin versus placebo from first trimester to delivery in polycystic ovary syndrome: a randomized, controlled multicenter study.

Metformin treatment from first trimester to delivery did not reduce pregnancy complications in PCOS and women in the metformin group gained less weight during pregnancy compared with those in the placebo group.