TITLE:
Predictive Factors of Successful Treatment of Gestational Diabetes with Metformin Monotherapy
AUTHORS:
Amr Mostafa Kamel Aboelfath, Mustafa Taha Abdelfattah Sharaf El din
KEYWORDS:
Gestational Diabetes, Metformin, Insulin
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.8,
August
14,
2020
ABSTRACT: Objective: To evaluate the factors affecting the success of metformin in management
of GDM. Methods: A prospective cohort study was done for 94 patients
diagnosed with GDM from April 2019 to March 2020 who needed pharmacological
treatments in addition to diet and lifestyle modification. Cases treated with
metformin monotherapy were compared with others who needed insulin in addition
to metformin for glycemic control. Patient characteristics, glycemic control
data and neonatal outcome were evaluated. Univariate and multivariate analysis
was done to find the independent factors affecting the success of metformin. Results: Of 94 patients with GDM who needed pharmacological treatment, 73
(77.6%) used only metformin for treatment of
GDM and 21 (22.4%) needed insulin to be added to metformin. Multivariate
analysis revealed that BMI was the only significant factor that affects the
success of metformin alone in control of GDM (p = 0.03). ROC curve of BMI
showed that the cut off value of the highest sensitivity is 32.1 above which
metformin monotherapy failed to control GDM. Conclusion: Metformin can
be considered as a safe and effective drug for treatment of GDM. Obesity was
found as a predictive factor for failure of metformin monotherapy.