comparison of metformin and insulin in treatment of gestational diabetes mellitus

Introduction: gestational diabetes mellitus (gdm) is one of the complications of pregnancy that has some maternal and neonatal outcomes. some drugs such as insulin and oral agents (metformin, ...) are used for management of gdm. the aim of this study was to compare metformin and insulin in treatment of gdm methods: this clinical trial was carried out in 2009-2011. sample size was 201 patients. patients were selected with block permutation and divided to two groups, including 156 women treated with insulin and 51 with metformin. single-blind for physicians, women treated with metformin, (500mg one or two times in a day). insulin administration was according to multi day injection program and starts with nph and regular insulin. blood sugar status of mothers and neonates and neonatal complications in both groups were followed up after discharge by telephone or direct interview. results: there were no statistically significant differences between both groups in maternal oral glucose tolerance test and fbs, and risk factors. no significant differences were seen in birth weight, head circumference, chest circumference, height, neonatal trauma, incidence of dystocia, neonatal trauma, respiratory distress, sepsis, fetus anomaly. the prevalence of first six months and second six months were similar in both groups but the prevalence of third six months and fourth six months were significantly increased in the group of women treated with insulin compared to women treated with metformin (p<0.001). conclusion: metformin therapy is clinically effective control of blood sugar in most of the women with gdm without any significant side-effects in the mother or in the fetus-neonate and it can be a safe alternative to insulin therapy.