1. The effect of metformin treatment of GDM-patients
on maternal BMI postpartum: the role of
maternal obesity
Outi Pellonperä, MD and Kristiina Tertti, MD, PhD
Turku University Hospital, Turku, Finland, Department of Obstetrics and Gynecology
University of Turku, Finland
Introduction
Materials and Methods
Pregnant women who had ≥ 2 pathologic glucose values at 2-hour 75g oral glucose tolerance test (OGTT), and needed medication to achieve sufficient glycemic control were randomized at gestational weeks to metformin or insulin treatment until delivery. BMI was measured at the first antenatal visit (baseline), 6-8 weeks and 1 year postpartum. The change in BMI of obese women (BMI >30 kg/m2) between metformin (n= 39) and insulin (n=38) groups was compared 6-8 weeks and 1 year postpartum. Similarly, the change in BMI of normal weight (BMI <25 kg/m2) women between metformin (n= 21) and insulin (n= 18) groups was compared.
Metformin can be used as an alternative medication to insulin in the treatment of gestational diabetes mellitus (GDM). Metformin reduces gestational weight gain in GDM-patients compared to insulin and there is indication that the positive effect on weight could persist 6-8 weeks after delivery. The aim of this study was to explore the role of prepregnancy obesity and gestational metformin treatment on weight gain 6-8 weeks and one year postpartum.
Results
There were no significant differences in the change in BMI between the obese women in metformin and insulin groups 6-8 weeks or 1 year after delivery ( p=0.079). The change in BMI of normal weight women did not differ between the two groups either (p=0.899). Overall, obese women lost weight significantly between first antenatal visit and 6-8 weeks postpartum (p<0.001).
Conclusions
Relatively short-term treatment with metformin of obese or normal weight GDM-patients does not affect postpartum-BMI compared to insulin.
Group effect p-value: difference in BMI between groups irrespective of time
Time effect p-value: difference in BMI between time points irrespective of group
Group*Time effect p-value: difference in the change of BMI between groups in the course of trial time
Data are presented as numbers or means ± standard deviations
Participants with baseline measurement and at least one follow-up measurement are included
P-values were calculated with repeated measures of ANCOVA
1data available for n number of participants