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Metformin and Gestational Diabetes: Efficacy During Pregnancy

During pregnancy, women can develop gestational diabetes mellitus (GDM). It is affecting 2 to 10% of expectant mothers in the United States, according to the Centers for Disease Control and Prevention (CDC). Managing this condition is crucial for a healthy pregnancy and birth. Metformin, a medication commonly prescribed for type 2 diabetes, has recently gained interest as a potential treatment for diabetes in pregnant women. In this article, we will examine the role of Metformin in diabetes management during pregnancy and several clinical studies to support its safe use. We will also consider some important tips to prevent this condition. Additionally, you can buy Metformin from Canada online to manage it.

How Does Gestational Diabetes Affect Pregnancy?

It is a type of diabetes that usually develops in the second or third trimester of pregnancy. It happens when the body cannot make sufficient insulin to meet the raised needs during pregnancy, leading to increased blood sugar levels. Between 24 and 28 weeks of pregnancy is the most common time for doctors to test for it. It is often possible to manage by eating healthy foods and exercising regularly. However, there are times when the patients must consider treatment options such as Metformin.

Gestational diabetes, if not managed properly, can lead to various complications for both the pregnant woman and the developing baby. Here are some potential complications associated with it during pregnancy:

1. Macrosomia (Having a Large Size Baby)

When diabetes is not managed properly, the baby’s blood sugar level is high. As a result, the baby is overfed and grows to a very large size. The extra-large baby can cause discomfort to the mother during her last few months of pregnancy, as well as problems during delivery for both mother and child. During delivery, the mother might need a C-Section. It is possible for the baby to be born with nerve damage due to pressure on the shoulder during delivery.

2. Birth by Cesarean Section (C-Section)

It is a surgical procedure to deliver a baby through the mother’s abdomen. Poorly controlled diabetes increases the likelihood of requiring a C-section for delivery. This surgical intervention, while necessary in some cases, extends the postpartum recovery period for the mother. The decision for a C-section is often made to ensure the safety of both the mother and the baby, particularly when managing the complexities associated with diabetes during pregnancy.

3. Preeclampsia (High Blood Pressure)

Women with preeclampsia often have high blood pressure and protein in their urine, as well as swelling in their fingers and toes that doesn’t go away. Their doctor must monitor and manage this serious problem closely. It is possible for both the mother and her unborn child to suffer from high blood pressure during pregnancy. During labor and delivery, it may cause the baby to be born prematurely as well as cause seizures or a stroke (a blood clot or bleeding in the brain that may damage the brain). Diabetic women are more likely to have high blood pressure than non-diabetic women.

4. Hypoglycemia (Low Blood Sugar)

Taking insulin or other diabetes medications can cause low blood sugar in people with diabetes. Without prompt treatment, low blood sugar can be very serious, even fatal. A pregnant woman can avoid serious low blood sugar by closely monitoring her blood sugar and treating it as soon as possible. After birth, a woman’s baby could suffer from low blood sugar if she didn’t control her diabetes during pregnancy. It is important to monitor the baby’s blood sugar after delivery for several hours.

5. Respiratory Distress Syndrome (RDS)

Infants born to mothers with uncontrolled gestational diabetes face a heightened risk of Respiratory Distress Syndrome (RDS). This ailment hampers the newborn’s respiratory function, potentially necessitating medical intervention. The compromised ability to breathe independently underscores the importance of managing the condition to mitigate risks and ensure the well-being of both mother and baby.

6. Polyhydramnios (Excessive Amniotic Fluid)

Inadequately managed gestational diabetes may lead to Polyhydramnios, marked by an abnormal buildup of amniotic fluid. This condition heightens the chances of preterm birth and complicates the delivery process. The excess amniotic fluid can pose challenges during childbirth, emphasizing the importance of complete control over the condition to safeguard both maternal and fetal well-being.

How Does Metformin Treat Gestational Diabetes?

Metformin belongs to the class of drugs known as biguanides, and it is commonly prescribed to treat type 2 diabetes. In managing the condition, it plays several roles:

Step 1. Insulin Sensitization: It improves insulin sensitivity in the body and enhances cells’ responsiveness to insulin, which is a hormone that helps regulate blood glucose levels. It helps the body utilize insulin more effectively, leading to better blood sugar control.

Step 2. Hepatic Glucose Production: It reduces the amount of glucose the liver makes. The liver normally releases glucose into the bloodstream, especially during periods of fasting. It helps decrease overall blood glucose levels.

Step 3. Glucose Uptake in Cells: It promotes the use of glucose by cells, particularly muscle cells. This increased uptake contributes to lowering overall blood glucose levels.

Step 4. Weight Management: It may have an impact on body weight, and it can lead to less weight gain compared to other treatments. This is particularly relevant during pregnancy when excessive weight gain can pose risks.

Step 5. Reduced Severe Hypoglycemia: Its use in gestational diabetes is associated with a lower risk of severe hypoglycemia (very low blood sugar levels) compared to insulin therapy.

Despite the fact that Metformin is considered safe during pregnancy, individualized care is essential. It is important to consult with a healthcare provider before making treatment decisions, taking into account the pregnant woman’s specific needs and circumstances.

Is Metformin Safe for Gestational Diabetes Management? 

The safety of Metformin for the management of gestational diabetes has been studied in various clinical trials, and several researches support its safety. Here are some key findings from clinical studies:

#1. Metformin Vs Insulin for the Treatment of Gestational Diabetes

In a study published by The New England Journal of Medicine in May 2008 involving 751 women with gestational diabetes mellitus between 20 to 33 weeks of gestation. The participants were randomly assigned to either open treatment with Metformin or insulin. The study aimed to rule out a 33% increase in this composite outcome in infants of women treated with Metformin compared to those treated with insulin. 

Among the 363 women given Metformin, 92.6% continued until delivery, with 46.3% also receiving supplemental insulin. The primary outcome rate was 32.0% for Metformin and 32.2% for insulin, showing no significant difference. More women in the metformin group (76.6%) preferred their treatment compared to insulin (27.2%). Additionally, there were no serious adverse events associated with the use of this medication. These findings support the safety and acceptability of Metformin in the management of diabetes during pregnancy.

#2. Metformin for Gestational Diabetes in Clinical Practice

Using data from the National Women’s Health database, Wiley Online Library (the leading provider of educational and research materials globally) examined prospectively collected data of women with gestational diabetes. A total of 1,269 women with the condition were delivered between January 2007 and December 2009. The following treatments were compared: diet alone in 371 women, insulin in 399 women, and Metformin in 465 women (249 on Metformin alone and 216 on both Metformin and insulin). The key findings are as follows:

  1. The BMIs and fasting glucose levels of women treated with Metformin and/or insulin were higher than those in the diet group at diagnosis.
  2. When compared to those treated with Metformin or diet, women treated with insulin had higher rates of Cesarean delivery (45.6% insulin, 37% metformin, 34% diet).
  3. Compared to the metformin and diet groups, insulin-treated women had higher rates of preterm births (19.2% insulin, 12.5% metformin, 12.1% diet).
  4. A higher percentage of insulin-treated women delivered large infants (18.5% insulin, 12.5% metformin, 12.4% diet) than metformin-treated women.
  5. When compared to the metformin and diet groups, insulin-treated women were more likely to need neonatal admissions (18.7% insulin, 12.7% metformin, 14.0% diet).
  6. Compared to metformin and diet groups, insulin-treated women used more neonatal intravenous dextrose (the administration of a glucose solution directly into a newborn’s bloodstream), i.e. 11.1% insulin, 5.1% metformin and 7.4 % diet.

Overall, the usage of Canadian pharmacy Metformin in gestational diabetes was linked with fewer negative results compared with insulin. However, it’s important to note that baseline differences between treatment groups may have contributed to these outcomes.

#3. Metformin vs. Insulin Treatment in Women with Gestational Diabetes 

Another Study was published by Wiley Online Library in July 2009. Initially, 127 women with gestational diabetes received metformin 500 mg twice daily, with dose titration to reach target blood glucose values. 100 women with the condition were treated with Metformin exclusively, and their outcomes were compared to those of 100 women treated with insulin. In addition to age and weight, ethnicity was also taken into consideration. The results were:

  • Women treated with insulin gained significantly more weight during pregnancy compared to those on Metformin.
  • There were no significant differences between the metformin and insulin groups for:
    1. Gestational hypertension (6 vs. 7%)
    2. Pre-eclampsia (9 vs. 2%)
    3. Induction of labor (26 vs. 24%)
    4. Rate of Cesarean section (48 vs. 52%)
  • Neonatal morbidity was better in the metformin group:
    1. Lower rates of prematurity (0 vs. 10%)
    2. Lower rates of neonatal jaundice (8 vs. 30%)
    3. Lower rates of admission to the neonatal unit (6 vs. 19%)
  • The incidence of macrosomia (high birth weight) was 14% for Metformin and 25% for insulin.

Overall, the women with gestational diabetes were treated with Canadian pharmacy metformin and with similar baseline adverse factors for negative pregnancy outcomes. The weight gain was less and neonatal outcomes were better than insulin.

#4. Is Metformin Use Controversial in Pregnancy?

While the drug has its benefits, concerns arise among healthcare providers due to its ability to cross the placenta. A study published by the National Centre for Biotechnology Information in April 2018, found that children exposed to the medicine have similar body fat levels to those whose mothers received insulin alone. Interestingly, by the age of 9, children exposed to Metformin were larger in comparison. This study suggests that the drug, when exposed to fetal environmental factors, can influence offspring development.

Tips to Help Pregnant Women Manage Gestational Diabetes

Here are several tips to help pregnant women effectively manage their diabetes:

Follow a Healthy Diet Plan

Follow a meal plan designed for people with diabetes to eat healthy foods. You can create a healthy meal plan with the help of a dietitian. They can also help you control your blood sugar during pregnancy. You can opt for whole grains, lean proteins, fruits, and vegetables. Limit the intake of refined sugars and processed foods.

Maintain a Regular Exercise Routine

Another method to sustain a healthy blood sugar level is to work out. By doing so, you can balance your food intake. You can work out daily during and after pregnancy after consulting your doctor. Five days a week, getting at least 30 minutes of low-to-moderate physical activity like walking, swimming, or prenatal yoga can be beneficial for maintaining blood sugar levels.

Maintain a Regular Blood Sugar Level

As the body’s energy needs change during pregnancy, blood sugar levels can alter. As directed by your doctor, check your blood sugar often. Keeping a log of your blood sugar readings can provide valuable information for both you and your healthcare team.

If You Need Insulin, Take It

Sometimes it is necessary for a pregnant woman with diabetes to take insulin. In order to keep blood sugar under control, take insulin as directed by your doctor. Some women may be apprehensive about insulin use, but it is a safe and effective way to manage blood sugar during pregnancy.

Take a Diabetes Test After Pregnancy

A diabetes test should be done 6 to 12 weeks after the birth of your baby and then every 1 to 3 years after that. Gestational diabetes often resolves after delivery, but for some women, it may persist or transition into type 2 diabetes. Additionally, if you want to buy Metformin from Canada, Polar Bear Meds is the best Canadian online pharmacy for all your medication needs.

Read Also – Why Experts Don’t Recommend Semaglutide During Pregnancy?

Final Words

It is crucial to manage gestational diabetes in order to ensure a healthy pregnancy. Even though Metformin has shown promising results in various studies, it should be used with caution due to concerns about its effects on fetal development. The clinical evidence suggests its safety and efficacy, but individualized care is crucial. To manage the condition effectively, you should maintain a healthy diet, exercise regularly, monitor your blood sugar, and, if needed, use insulin. A regular diabetes test post-pregnancy is essential. The best outcome for mother and child can be assured when healthcare providers collaborate with one another to make the best decisions.

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