Metformin versus insulin in gestational diabetes mellitus: a systematic review

Rev Bras Ginecol Obstet. 2024 Dec 4:46:e-rbgo89. doi: 10.61622/rbgo/2024rbgo89. eCollection 2024.

Abstract

Objective: The aim of this study is to assess the use of metformin with or without insulin for the treatment of Gestational Diabetes Mellitus compared to insulin alone.

Data sources: This article consists of a systematic review of randomized clinical trials. The searches were carried out on MEDLINE including 7 studies, between 2010 to 2021.

Study selection: Randomized clinical trials comparing metformin and insulin written in English, Spanish or Portuguese, with no time limit, were included.

Data collection: Data was extracted from all the 7 articles and compared statistically when possible. Whenever data was not available or couldn't be statistically compared, the main results were described in detail.

Data synthesis: Insulin alone is not superior than metformin with or without insulin on gestational diabetes mellitus.

Conclusion: There is a potential viability of using metformin as an alternative compared to insulin alone in the treatment of Gestational Diabetes Mellitus. However, all assessed outcomes have a very low level of certainty of evidence and more studies are necessary to support these findings.

Keywords: Gestational diabetes; Insulin therapy; Metformin; Pregnancy complications.

Publication types

  • Systematic Review
  • Comparative Study
  • Review

MeSH terms

  • Diabetes, Gestational* / drug therapy
  • Drug Therapy, Combination
  • Female
  • Humans
  • Hypoglycemic Agents* / therapeutic use
  • Insulin* / therapeutic use
  • Metformin* / therapeutic use
  • Pregnancy
  • Randomized Controlled Trials as Topic

Substances

  • Metformin
  • Hypoglycemic Agents
  • Insulin