Metformin study offers hope for pregnant women with diabetes

Drug reduces insulin need, improves sugar control and lowers weight gain, with minimal side effects

A University of Galway study shines a hopeful light on the safety and efficacy of metformin for expectant mothers. PA

The drug metformin offers promising treatment benefits for gestational diabetes, a study from the University of Galway has found.

This condition, affecting nearly three million pregnant women worldwide each year, carries increased health risks for mothers and newborns.

The research led by Prof Fidelma Dunne, a consultant endocrinologist, evaluated the effects of metformin on pregnant women who have gestational diabetes.

The trial's results were published in Jama: the Journal of American Medical Association.

“Traditionally, gestational diabetes management revolved around dietary advice and physical activity, with insulin as the next line of treatment," Prof Dunne told the 59th annual meeting of the European Association for the Study of Diabetes in Hamburg, Germany.

"Though effective, insulin can present complications."

To try to find a safer and more effective alternative, the research team explored metformin, a drug with a six-decade history in treating Type 2 Diabetes.

The Emerge study, a randomised, placebo-controlled trial, engaged more than 500 pregnant participants and brought encouraging outcomes.

Women who were treated with metformin were 25 per cent less likely to need insulin. When it was required, insulin introduction occurred later in their pregnancy.

Participants on metformin displayed better sugar control, particularly during the 32nd and 38th weeks of gestation.

These women also experienced less weight gain throughout the study, a trend that persisted 12 weeks after giving birth.

Birth timings were comparable for the metformin and placebo groups, with no increase in preterm deliveries among those on metformin.

Infants born to mothers on metformin were, on average, 113g lighter, and there were fewer instances of them being classified as “large at birth”.

While a slight decrease in infant length was noted for the metformin group, other measurements were largely consistent with those of the placebo group.

No significant differences were found in adverse neo-natal outcomes or maternal complications during or after delivery.

“Metformin has emerged as a powerful alternative in gestational diabetes management," Prof Dunne said.

"It stands as a beacon of hope not just for expectant mothers, but for healthcare providers across the globe.”

This landmark study successfully dispelled lingering concerns over metformin, especially pertaining to preterm birth and infant size.

A vast majority (98 per cent) of participants continued the trial until delivery, and only a minimal 4.9 per cent discontinued the medication because of side-effects, underscoring its safety.

“The Emerge study reshapes our understanding of gestational diabetes treatment," Prof Dunne said.

"With the evident benefits of metformin, expectant mothers worldwide can now have more confidence in their treatment options."