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Evid Based Med doi:10.1136/eb-2013-101329
  • Therapeutics
  • Randomised controlled trial

Should metformin be preferred over insulin therapy in the management of gestational diabetes (GDM)?

  1. Shannon D Sullivan
  1. Department of Endocrinology & Metabolism, Medstar Washington Hospital Center, Washington, DC, USA
  1. Correspondence to: Dr Shannon D Sullivan
    Department of Endocrinology & Metabolism, Medstar Washington Hospital Center, 110 Irving Street, NW Suite 2A-72, Washington, DC, 20010, USA; Shannon.D.Sullivan{at}Medstar.net

Commentary on: Barrett HL, Gatford KL, Houda CM, et al. Maternal and neonatal circulating markers of metabolic and cardiovascular risk in the Metformin in Gestational Diabetes (MIG) trial: Responses to maternal metformin versus insulin treatment. Diabetes Care 2013;36:529–36.

Context

In this ancillary study of the Metformin in Gestational Diabetes (MiG) Trial, a prospective, randomised, multicentre trial in New Zealand and Australia, the investigators compare several circulating markers of metabolic risk in women with gestational diabetes (GDM) and in the cord blood of their offspring, to determine the differences between those treated with metformin or insulin during pregnancy.

Methods

In 236 metformin-treated and 242 insulin-treated women, fasting glucose, lipids, triglycerides (TGs), high-density lipoprotein, low-density lipoprotein and C reactive protein (CRP) were measured at randomisation (20–33 weeks’ gestation), at 36 weeks and at 6–8 weeks postpartum, as well as in cord blood. Treatment-group differences in maternal glucose, lipids and CRP levels …