The Effect of Metformin in Gestational Diabetes

Abstract

Gestational diabetes is glucose intolerance identified in the second trimester of pregnancy. This occurs mainly due to the diabetogenic effects of placental hormones and is associated with certain critical fetal and maternal consequences. 1 If maternal normoglycaemia cannot be achieved by diet and lifestyle changes, medication will be needed. The standard treatment for achieving adequate glucose levels is insulin therapy. However, the disadvantages of insulin for the mother include the need for injections, risk of hypoglycaemia, increased appetite and weight gain. Furthermore, this treatment requires modification based on the patient's body mass index, glucose levels and lifestyle . 2 Metformin appears to be a viable option for use in GDM. This medication with a different mode of action from insulin is an antihyperglycemic agent Its primary mechanism of action is in reducing hepatic glucose production. Secondarily, it decreases intestinal absorption of glucose and improves insulin sensitivity by increasing peripheral glucose uptake and utilization and does not cause either hypoglycemia or hyperinsulinemia.