{"title":"二甲双胍联合或不联合胰岛素治疗妊娠期糖尿病的母婴结局。","authors":"Abhinav Kumar, J Muthukrishnan, Ankita Patel, Burle Chaitanya Kiran","doi":"10.1007/s13224-025-02124-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Gestational Diabetes Mellitus (GDM) is linked with a multitude of adverse perinatal outcomes. There is a want for standard guidelines regarding the usage of Metformin in GDM. We aimed to study the perinatal outcomes in women diagnosed with GDM treated primarily with Metformin with or without Insulin.</p><p><strong>Methods: </strong>We conducted a randomized controlled pilot study. with a total of 75 women, divided into three groups: GDM treated with Metformin with or without Insulin (Group M), GDM on Insulin alone (Group I), and healthy pregnant women as controls (Group H), with 25 subjects in each group. At delivery, fetal and maternal outcomes were documented.</p><p><strong>Results: </strong>The mean age in groups M, I and H were 27.4, 26.2, and 27.3 years respectively. The baseline mean HOMA-IR were 3.9 and 4.1 for Group M and Group I, respectively (<i>p</i>-0.560). The mean fetal birth weight was 2.95 ± 0.54 kg, 2.8 ± 0.41 kg, and 2.97 ± 0.65 kg in Groups M, H, and I, respectively (<i>p</i> = 0.527). The mean newborn HOMA-IR in Groups M and I was 1.8 ± 0.4 and 1.7 ± 0.5, respectively (<i>p</i> = 0.185). The adverse events in newborns were 20% (<i>n</i> = 5), 16% (<i>n</i> = 4) and 16% (<i>n</i> = 4) in Groups M, H, and I respectively (<i>p</i> = 0.403). The incidence of caesarean deliveries was 40% (<i>n</i> = 10), 48% (<i>n</i> = 12) and 24% (<i>n</i> = 6) in Groups M, H, and I respectively (<i>p</i>-0.253).</p><p><strong>Conclusion: </strong>The study revealed identical maternal and fetal outcomes in women treated with Metformin as the primary drug compared to conventional treatment with Insulin in GDM.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 4","pages":"304-310"},"PeriodicalIF":0.6000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367571/pdf/","citationCount":"0","resultStr":"{\"title\":\"Maternal and Fetal Outcomes in Gestational Diabetes Mellitus Treated with Metformin with or Without Insulin.\",\"authors\":\"Abhinav Kumar, J Muthukrishnan, Ankita Patel, Burle Chaitanya Kiran\",\"doi\":\"10.1007/s13224-025-02124-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Gestational Diabetes Mellitus (GDM) is linked with a multitude of adverse perinatal outcomes. There is a want for standard guidelines regarding the usage of Metformin in GDM. We aimed to study the perinatal outcomes in women diagnosed with GDM treated primarily with Metformin with or without Insulin.</p><p><strong>Methods: </strong>We conducted a randomized controlled pilot study. with a total of 75 women, divided into three groups: GDM treated with Metformin with or without Insulin (Group M), GDM on Insulin alone (Group I), and healthy pregnant women as controls (Group H), with 25 subjects in each group. At delivery, fetal and maternal outcomes were documented.</p><p><strong>Results: </strong>The mean age in groups M, I and H were 27.4, 26.2, and 27.3 years respectively. The baseline mean HOMA-IR were 3.9 and 4.1 for Group M and Group I, respectively (<i>p</i>-0.560). The mean fetal birth weight was 2.95 ± 0.54 kg, 2.8 ± 0.41 kg, and 2.97 ± 0.65 kg in Groups M, H, and I, respectively (<i>p</i> = 0.527). The mean newborn HOMA-IR in Groups M and I was 1.8 ± 0.4 and 1.7 ± 0.5, respectively (<i>p</i> = 0.185). The adverse events in newborns were 20% (<i>n</i> = 5), 16% (<i>n</i> = 4) and 16% (<i>n</i> = 4) in Groups M, H, and I respectively (<i>p</i> = 0.403). The incidence of caesarean deliveries was 40% (<i>n</i> = 10), 48% (<i>n</i> = 12) and 24% (<i>n</i> = 6) in Groups M, H, and I respectively (<i>p</i>-0.253).</p><p><strong>Conclusion: </strong>The study revealed identical maternal and fetal outcomes in women treated with Metformin as the primary drug compared to conventional treatment with Insulin in GDM.</p>\",\"PeriodicalId\":51563,\"journal\":{\"name\":\"Journal of Obstetrics and Gynecology of India\",\"volume\":\"75 4\",\"pages\":\"304-310\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367571/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Obstetrics and Gynecology of India\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s13224-025-02124-6\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Obstetrics and Gynecology of India","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s13224-025-02124-6","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/7 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Maternal and Fetal Outcomes in Gestational Diabetes Mellitus Treated with Metformin with or Without Insulin.
Background: Gestational Diabetes Mellitus (GDM) is linked with a multitude of adverse perinatal outcomes. There is a want for standard guidelines regarding the usage of Metformin in GDM. We aimed to study the perinatal outcomes in women diagnosed with GDM treated primarily with Metformin with or without Insulin.
Methods: We conducted a randomized controlled pilot study. with a total of 75 women, divided into three groups: GDM treated with Metformin with or without Insulin (Group M), GDM on Insulin alone (Group I), and healthy pregnant women as controls (Group H), with 25 subjects in each group. At delivery, fetal and maternal outcomes were documented.
Results: The mean age in groups M, I and H were 27.4, 26.2, and 27.3 years respectively. The baseline mean HOMA-IR were 3.9 and 4.1 for Group M and Group I, respectively (p-0.560). The mean fetal birth weight was 2.95 ± 0.54 kg, 2.8 ± 0.41 kg, and 2.97 ± 0.65 kg in Groups M, H, and I, respectively (p = 0.527). The mean newborn HOMA-IR in Groups M and I was 1.8 ± 0.4 and 1.7 ± 0.5, respectively (p = 0.185). The adverse events in newborns were 20% (n = 5), 16% (n = 4) and 16% (n = 4) in Groups M, H, and I respectively (p = 0.403). The incidence of caesarean deliveries was 40% (n = 10), 48% (n = 12) and 24% (n = 6) in Groups M, H, and I respectively (p-0.253).
Conclusion: The study revealed identical maternal and fetal outcomes in women treated with Metformin as the primary drug compared to conventional treatment with Insulin in GDM.
期刊介绍：
Journal of Obstetrics and Gynecology of India (JOGI) is the official journal of the Federation of Obstetrics and Gynecology Societies of India (FOGSI). This is a peer- reviewed journal and features articles pertaining to the field of obstetrics and gynecology. The Journal is published six times a year on a bimonthly basis. Articles contributed by clinicians involved in patient care and research, and basic science researchers are considered. It publishes clinical and basic research of all aspects of obstetrics and gynecology, community obstetrics and family welfare and subspecialty subjects including gynecological endoscopy, infertility, oncology and ultrasonography, provided they have scientific merit and represent an important advance in knowledge. The journal believes in diversity and welcomes and encourages relevant contributions from world over. The types of articles published are: · Original Article· Case Report · Instrumentation and Techniques · Short Commentary · Correspondence (Letter to the Editor) · Pictorial Essay
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