Pregnancy outcomes in pregnant women with diabetes treated with insulin alone and insulin with metformin

Introduction: The goal of this study was to compare maternal and neonatal results in diabetic pregnant ladies who were treated either insulin and metformin or insulin only. Methods: 220 pregnant diabetic women with type 1, 2 or gestational diabetes were randomisely assigned into two groups.each group is 110 pregnant diabetic women. One group takes insulin and metformin treatment to achieve glycemic targets and other take insulin only treatment. Pregnancy results in 110 ladies who stayed solely on insulin have been compared to pregnancy results in 110 pregnant diabetic ladies treated with insulin and metformin who were matching for age, weight, as well as ethnicity. Results: Inulin only group gained significantly more weight but no statistical differences were found in gestational hypertension, pre-eclampsia, vaginal delivery, elective Caesarean section, and perinatal loss despite significantly lower insulin dosage. Combination of insulin and metformin significantly lower rate of neonatal morbidity such as neonatal hypoglycemia, respiratory distress, and neonatal jaundice. The lower macrosomia rate and incidence of polyhydramnios were also observed. Conclusions: Diabetic pregnant women who were treated with insulin plus metformin who had equal baseline risk factors for unfavourable pregnancy outcomes gained less weight and needed less insulin to maintain glycemic control but with significant improvement in prenatal morbidit compared with those treated with insulin alone.