Maternal Weight Gain in Gestational Diabetes Controlled by Metformin Versus Insulin
Gestational Diabetes
About this trial
This is an interventional other trial for Gestational Diabetes
Eligibility Criteria
Inclusion Criteria:
- Patients aged (19-35) years
- BMI 18-30 kg/m2
- Gestational age >24 weeks
- Singleton pregnancy
- Gestational diabetes mellitus with failure to achieve adequate glucose control on diet therapy alone (FBG > 105) OR patients with gestational diabetes who are controlled with either metformin alone or insulin alone.
Exclusion Criteria:
- Pregnant women with preexisting diabetes mellitus
- Women who have contraindication to take metformin e.g.: impaired renal function, hepatic cirrhosis, hepatitis).
- Patients with other medical disorders that could affect perinatal outcome (e.g., hypertension, SLE etc).
- Fetal anomalies identified on ultrasound prior to initiation of therapy.
- Patients who refused to participate
Sites / Locations
- Ain SHams Maternity Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Insulin Group
Metformin Group
This includes women with GDM allocated to receive insulin treatment. Starting dose will be 30unit (20 unit intermediate dose + 10 unit rapid acting insulin) in the morning and before breakfast). In the 2nd trimester, we will start with half of the previous dose and if post dinner glucose level remain elevated additional injection of rapid acting insulin will be given just prior to dinner. If fasting glucose is elevated, intermediate acting insulin can be given along with the dinner dose of rapid acting insulin.
This includes women with GDM allocated to receive metformin treatment. They will receive an initial metformin dose of 500 mg once or twice daily (according to initial blood glucose level) with food and increased 500 mg every one or two weeks toward targets or up to a maximum daily dose of 2500 mg divided doses with each meal.