Comparative Study between Metformin and Insulin in Controlling uncomplicated Gestational Diabetes Mellitus

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Gestational diabetes always accompanies an increased maternal and neonatal risk. Insulin is the standard therapy but causes multiple complications. Metformin has less complications. This study aims to assess the efficacy of metformin in controlling maternal blood glucose level compared to insulin in women with gestational diabetes .A randomized controlled trial conducted in the obstetric department in Salah Al-Deen general Hospital during the period from 1st February - 31st July 2022. Total sample of 100 pregnant women suffered from gestational diabetes at (24-28week) gestational age were recruited randomly. The patients were divided into two groups: 1-Metformin group (50 patients). 2-Insulin Group (50 patients). Fasting and post prandial blood glucose levels 2 h after breakfast were done at each visit and HbAlc each trimester. Follow up was continued till delivery to evaluate the pregnancy outcome The mean HbAlc was significantly higher among Insulin group (5.8± 0.5) than in Metformin group (5.4 ± 0.8). Preeclampsia was lower among Metformin group (14%) than Insulin group (19.6%). hypoglycemia episode was significantly lower among Metformin group (14%) than Insulin group (41.3%), Caesarean delivery was higher among Insulin group (58.7%) than Metformin group (37.2%). The mean birth weight was significantly higher among Insulin group (3761.4±470) than Metformin group (3540.9±338). Prematurity was found among (8.7%) of the Insulin group in comparison to (4.7%) of the Metformin group. Prematurity was non significantly higher among Insulin group (8.7%) than Metformin group (4.7%) .Metformin is effective and safe in the glycemic control of gestational diabetes, with better maternal and neonatal outcomes.