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Re: Metformin versus Insulin for the Treatment of Gestational DiabetesFrom: Marie Harkins (mharkins@twcny.rr.com)Sun May 11 06:29:24 2008
I just returned from a conference on GDM and obesity where Donald Coustan was one of the main speakers. He discussed this paper and the use of Metformin for GDM treatment. He was reluctant to advocate for use of Metformin for GDM and sited a study from Vankey et.al. (Fertil Steril 83:1575,2005). This study had a small number of women (n) taking Metformin throughout pregnancy and measured maternal serum and cord artery and vein levels simultaneously at birth. All cord bloods contained Metformin at higher levels than maternal serum. As mentioned in the article below, Metformin is a small molecule that crosses the placenta. Dr Coustan felt that fetal effects of Metformin have not been well studied and and that more trials or animal studies would be helpful. On the other hand, he presented good evidence that Metformin does improve early pregnancy loss rate in women with PCOS, even if it is discontinued at the time of diagnosis of pregnancy.
-- Marie Harkins, CNM Ithaca, NY
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