Treatment of GDM with Metformin tied to Favourable Lipid Profile in Offsprings

Metformin is widely used in the treatment of gestational diabetes. However, it is not known whether exposure to metformin in utero has late metabolic effects on the child. Therefore, Dr Elisa Paavilainen MD and her team conducted a study to compare anthropometrics, lipid, and glucose metabolism in 9-year-old offspring of mothers treated with metformin or insulin for gestational diabetes mellitus.

It was an open-label, randomized, two-centre, 9-year follow-up Finnish study. The researchers included a total of 172 children (82 from the metformin and 90 from the insulin group). They compared the effects observed on the offspring of mothers who have received metformin and insulin treatment for GDM. They evaluated anthropometrics, blood pressure, lipoproteins, and oral glucose tolerance test.

Key Findings of the Study were:

• Upon analysis, the researchers found no difference in 9-year-old offspring's anthropometric variables, including body mass index and waist-to-height ratio.
• However, they noted that offspring in the metformin group had higher high-density lipoprotein cholesterol (HDL-C) concentrations (1.72 vs 1.54 mmol/L) but lower low-density lipoprotein cholesterol (2.39 vs 2.58 mmol/L) and apolipoprotein B concentrations (0.63 vs 0.67g/L) than the offspring in the insulin group.
• They also noted that the difference in the HDL-C concentration was found to be significant only in boys.
• They observed that the 2-hour glucose value in the oral glucose tolerance test was 0.6 mmol/L lower in boys from the metformin group than in those from the insulin group.

The authors concluded, "Metformin treatment for GDM is associated with similar offspring growth and glucose metabolism but a more favourable lipid profile at the age of 9 years as compared to insulin treatment."

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DOI: https://doi.org/10.1111/dom.14589