Metformin vs Insulin in the Management of Gestational Diabetes; A Randomized Controlled Trial

Abstract

Objectives: To compare the efficacy in terms of glycemic control of insulin versus metformin in gestational diabetes mellitus.

Methodology: This Randomized Controlled trial conducted in Department of Obstetrics & Gynecology at Pakistan institute of medical sciences, Islamabad from January 2022 to July 2022. A total of 100 pregnant women with gestational diabetes mellitus and gestational age of >20 weeks of age 18-40 years were selected. Women with multiple pregnancy and already taking treatment for gestational diabetes mellitus were excluded. Patients in the group A were given injection regular insulin by subcutaneous route and group B was given tablet metformin 500mg by oral route. Patients were admitted for 1 week in 2nd and 3rd trimester for glycemic control. All the patients were put on 6 hourly sugar profile at which efficacy was noted.

Results: The mean age of women in group A was 27.86 ± 4.17 years, and in group B was 28.22 ± 3.97 years. Majority of the patients 64 (64.0%) were between 18 to 30 years of age. The mean gestational age of women in group A was 25.04 ± 3.26 weeks and in group B was 24.60 ± 3.30 weeks. In this study, the efficacy of metformin versus insulin in terms of glycemic control was 74.0% versus 32.0% respectively, p = 0.0001.

Conclusion: This study concluded that there is better glycemic control with metformin compared to regular insulin in managing gestational diabetes mellitus.