The emerging role of metformin in gestational diabetes mellitus

Gray, Susan G. , Mcguire, Treasure M. , Cohen, Neale and Little, Peter J. (2017) The emerging role of metformin in gestational diabetes mellitus. Diabetes, Obesity and Metabolism, . doi:10.1111/dom.12893


Author Gray, Susan G.
Mcguire, Treasure M.
Cohen, Neale
Little, Peter J.
Title The emerging role of metformin in gestational diabetes mellitus
Journal name Diabetes, Obesity and Metabolism   Check publisher's open access policy
ISSN 1463-1326
1462-8902
Publication date 2017-03-24
Sub-type Article (original research)
DOI 10.1111/dom.12893
Open Access Status Not yet assessed
Total pages 8
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2018
Language eng
Abstract Metformin use during pregnancy is controversial and there is disparity in the acceptance of metformin treatment in women with gestational diabetes mellitus (GDM) in Australia. Despite short term maternal and neonatal safety measures, the placental transfer of metformin during GDM treatment and the absence of long-term safety data in offspring has regulators and prescribers cautious about its use. To determine the current role in GDM management, this literature review describes the physiological changes that occur in GDM and other forms of diabetes in pregnancy (DIP) and international changes in guidelines for GDM diagnosis. Management options are considered, with a focus on the evolving evidence for metformin, its mechanism of action, the maternal, foetal and neonatal outcomes associated with its use and benefit vs risk when compared with the current gold standard, insulin. Investigation reveals a favourable balance of evidence to support the safety and long-term benefits, to mother and child, of using metformin as an alternate to insulin for treatment of GDM. Recent findings of the gastrointestinal-directed action of metformin are at least as important as the hepatic effect and the availability of a novel delayed-release metformin dose form to exploit this new information provides a product and therapeutic strategy ideally suited to the use of metformin in GDM.
Keyword Diabetes in pregnancy
Gestational diabetes mellitus
Insulin
Metformin
Pharmacology
Therapeutics
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Health Services Publications
HERDC Pre-Audit
School of Pharmacy Publications
 
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