Being told you need to take medication to manage your glucose targets in pregnancy can make you feel like a failure. If this is the case, rest assured that it is simply due to those yummy hormones in pregnancy that are helping to grow a healthy baby, and not because you have done anything wrong.
Your options of medication to use in pregnancy to manage gestational diabetes include either metformin, insulin, or occasionally both. Taking any tablets in pregnancy may seem risky to your baby, so what is the lowdown on Metformin, it's risks and benefits to you and your little one?
Metformin is a commonly prescribed medication for Type 2 diabetes, and it's use in pregnancy has recently been well studied.
Maternal Outcomes
Maternal Weight Gain
Metformin use during pregnancy has been shown to reduce maternal weight gain, irrespective of the diagnosis that has led to the medication being prescribed (such as type 2 diabetes mellitus, GDM, Polycystic ovary syndrome (PCOS)).
Glycaemic Control
Metformin appears to be as effective as insulin in controlling blood glucose during pregnancy and some studies are now suggesting it is the better alternate to insulin use.
Need for Additional Insulin
Insulin is added when glycaemic targets are not met with metformin alone. It is suggested that 50% of women who take Metformin will need insulin therapy at some point in their pregnancy.
Pregnancy-Related Hypertensive Disorders
Some studies indicate a potential trend for a reduced risk of gestational hypertensive disorders with metformin use.
Caesarean Delivery
While hyperglycaemia during pregnancy is a known risk factor for caesarean delivery, there is a small body of research published that is suggesting it may reduce the number of caesarean births for women with diabetes.
Neonatal Outcomes
Gestational Age/Preterm Birth
Metformin administration during GDM treatment is associated with earlier gestational age, although the clinical significance of this can come for recommendations for induction of labour, and more research will be needed to determine the cause of earlier birth.
Birth Weight
Babies born to mothers taking metformin tend to have lower birth weight with reduced rates of macrosomia.
Neonatal Hypoglycaemia
Metformin use for GDM treatment is associated with a reduced risk of neonatal hypoglycaemia as in allows for greater glycaemic control in pregnancy.
Other Neonatal Complications
Metformin use during pregnancy is generally not associated with neonatal intensive care unit admissions, respiratory distress syndrome, or reduced APGAR score at 5 minutes.
Childhood Outcomes
Offspring Health
Long-term follow-ups of children born to mothers taking metformin during pregnancy indicate slightly increased rates on BMI, however a direct link is yet to be established.
Pharmacokinetics
Metformin's transplacental transmission raises concerns, but current evidence supports its safety in early gestation.
Studies are continuing in the area of Metformin use in pregnancy but current research shows that Metformin is a valuable tool in managing gestational diabetes.
It is essential for women who are taking Metformin to discuss the risks and benefits with their health care providers.
Get in touch
If you have any pregnancy and diabetes management questions please reach out using the contact page.
