Metformin and Gestational Diabetes

It’s been estimated that nearly one out of ten pregnant women in the United States develop what’s known as gestational diabetes. Gestational diabetes occurs during pregnancy and causes high blood sugar. Although it typically goes away after delivery, women who have experienced gestational diabetes remain at higher risk of developing Type 2 diabetes later in life.

However, data presented at the American Diabetes Association (ADA) Scientific Sessions indicates that long-term use of metformin — the well-known diabetes medication that sensitizes the body’s cells to insulin and decreases the amount of glucose released by the liver — has a powerful effect on preventing the development of Type 2 diabetes in women who have had gestational diabetes.

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The researchers drew their data from the Diabetes Prevention Program (DPP), an initiative launched in 1996. The purpose of the DPP was to determine whether lifestyle intervention or metformin would prevent or delay the onset of diabetes in high-risk patients. The patients were divided into three groups: one receiving lifestyle interventions, one receiving metformin twice a day, and one receiving a placebo. After the DPP ended in 2001, it was extended in a still-ongoing phase called the Diabetes Prevention Program Outcomes Study, in which the patients were offered ongoing therapy and continued to have their outcomes monitored.

After analyzing the data, the researchers determined that between the beginning of the DPP and today, the overall risk of diabetes was lowered by 18 percent in the metformin group. However, the results were much more impressive among women with a history of gestational diabetes — their risk was lowered by 41 percent. As David M. Nathan, MD, who presented the analysis at the ADA Scientific Sessions, told Medscape, “The overall results reinforce the long-lasting efficacy of metformin in reducing the development of diabetes and support its more widespread use as a prevention measure in those at high risk.”

Want to learn more about gestational diabetes? Read “Gestational Diabetes: What Are the Risks?” “Gestational Diabetes: Once You’re Diagnosed,” and “Gestational Diabetes: More Treatment Approaches.”

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  • Amy

    Fascinating. I’ve often wondered if my gestational diabetes was more a symptom than a cause of my prediabetes — it was only a few years after giving birth that my blood sugars were in the prediabetic range. I’ve made pretty drastic lifestyle changes, but I still worry about developing Type II in the future.

    It’s important to note that in this study, the lifestyle-change group had a 58% reduced risk of developing diabetes, a greater reduction than the metformin group overall. It would be interesting to know whether lifestyle change plus metformin yields even more protection against diabetes. Does the study report any adverse side effects of using metformin preventatively — that is, for individuals who are not yet diabetic?

  • Amy

    It’s important to note that in the study, the lifestyle-change group had a 58% reduction in diabetes risk — a greater overall reduction than the metformin-only group. It would be interesting to see whether lifestyle changes plus metformin would yield even more protection long-term.