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Randomised controlled trial
Metformin is not significantly different from insulin for preventing fetal macrosomia in women with gestational diabetes
  1. Steve L Hyer
  1. Diabetes Centre, Epsom & St Helier University Hospitals NHS Trust, Carshalton, UK
  1. Correspondence to Steve L Hyer
    Diabetes Centre, Epsom & St Helier University Hospitals NHS Trust, Wrythe Lane, Carshalton SM5 1AA, UK; steve.hyer{at}esth.nhs.uk

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Context

Evidence is accumulating that metformin is a safe alternative to insulin for the treatment of gestational diabetes mellitus (GDM) not adequately controlled by dietary measures alone.1 2 The UK National Institute for Health and Clinical Excellence (NICE) guidance for diabetes in pregnancy now includes metformin as a treatment option.3 However metformin is still not widely accepted for the management of GDM and remains unlicensed for this indication in the UK. The study by Ijas and colleagues adds to the evidence base for its use in GDM.

Method

In an open-label prospective study, the Finnish team randomised 100 women (out of a total of 128 eligible women) with singleton pregnancies diagnosed with GDM by oral glucose tolerance test (fasting capillary glucose 5.3 (baseline), 11.0 (1 h) and 9.6 (2 h) mmol/l after 75 g oral glucose) between 12 and 34 weeks of gestation …

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