Metformin versus insulin treatment in gestational diabetes in pregnancy and their effects on neonatal birthweight

Aim: to compare the maternal and neonatal outcomes (in terms of birthweight) in women treated with metformin versus insulin for the management of gestational diabetes mellitus. methods: this was a randomized clinical trial in nature. we included 60 women who presented with gestational diabetes mellitus. group i patients were given metformin therapy (500-2 grams) in intermittent doses daily for the management of gdm,and to group ii patients (control group) subcutaneous nph insulin was given. the dose of insulin and metformin was dependent upon the glycemic control of the patient. results: mean gestational age of the patients at the time of enrolment in study was 28.13±2.30 weeks in metformin group and 28.26±2.46 weeks in insulin group (p-value 0.82). mean weight gain was 8.96±1.78 kg in mothers taking metformin therapy and 9.36±1.40 kg in mother taking insulin therapy (p-value 0.33). the rate of cesarean section was 43.3% in metformin group and 36.7% in insulin group with a p-value of 0.59. in metformin group,the mean weight of babies at the time of birth was 3.2±0.20 kg versus 3.67±0.19 kg in insulin group (p-value <0.001). conclusion: metformin is a safe drug for the management of gestational diabetes mellitus because of its less monitoring and comparatively comparable maternal side effects. the only problem with metformin therapy is lower birthweight of neonates.