New gestational diabetes treatment safe

[T_Dia]

A controversial alternative to insulin injections for pregnant women with gestational diabetes is safe, Australian and New Zealand researchers say.

Gestational diabetes is a complication in about five per cent of pregnancies - and is on the rise.

Where it can't be controlled through diet and exercise, insulin therapy is often used to improve the health of both baby and mother.

But University of Adelaide Clinical Senior Lecturer Bill Hague says insulin therapy can also cause low blood glucose and weight gain in the mother.

A clinical trial of 751 women with gestational diabetes in Adelaide and Auckland compared insulin injections and the oral diabetic drug, metformin.

The results, published in The New England Journal of Medicine, show the babies of mothers treated with metformin were no different from the babies of mothers treated with insulin alone, either at birth or at 6-8 weeks of age.

Dr Hague said no serious adverse effects were associated with the use of metformin, which usually returned blood glucose to normal, rather than dropping it too low, and also is associated with maternal weight loss.

"More than half the women taking metformin could be managed with tablets alone," Dr Hague said.

"If extra insulin was necessary, the dose was less than that required for women taking insulin alone.

"Oral medication therefore can offer considerable advantages.

"Women in this trial certainly preferred to use metformin rather than insulin.

"To date, however, metformin use in pregnancy remains controversial - before this study there were only two reported small randomised trials comparing metformin with insulin."

The children born within the trial were being assessed at two years of age, and further follow up data was still needed, he said.
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