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Metformin
The MiG trial (2008) showed that use of metformin gives comparable outcomes to insulin
in the management of women with gestational diabetes. Women treated with metformin
had offspring with less severe neonatal hypoglycaemia. Such women gained less weight
during pregnancy and lost more weight after delivery. Women preferred treatment with
metformin. Follow up of the offspring to date has shown no difference between those
whose mothers were treated with insulin and those whose mothers were treated with
metformin
Long-term follow-up of children born to mothers with gestational diabetes who took
metformin during pregnancy has shown that, if anything, the children at 2 years have less
abdominal fat than children whose mothers had been managed with insulin alone12
.
Preliminary data from South Australia suggest that there are no significant differences in
neuro-cognitive capacity and IQ in the offspring exposed to metformin in utero at 6 to 7
years of age
The use of metformin in pregnancy is not currently endorsed by regulatory authorities or
professional bodies, including ADIPS. Although no adverse effects have been
demonstrated to date, metformin does cross the placenta, leading authorities to be very
cautious in their recommendations.
Nonetheless, metformin is used for the treatment of gestational diabetes in many centres
around Australia and New Zealand
Metformin could be considered for use in women who have failed non-drug treatments and
who either refuse or are unable to take insulin. The mother should be educated about the
potential risks, benefits and areas of uncertainty so that an informed decision can be
made.
Use of metformin should only be in consultation with a physician / endocrinologist with
specialised knowledge of its use in pregnancy
The above is from AU in-hospital guideline (consensus from RANZCOG and ADIPS) |
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新足迹读书半月谈 2009年6月下 —— 巴尔扎克 (2009-6-15) joaquin 
发表于 2019-2-22 19:33
