US Pharm. 2023;48(11):4.

Researchers at the University of Galway have taken a significant step forward in the management of gestational diabetes mellitus after a clinical trial involving pregnant women provided new hope for expectant mothers diagnosed with the condition. The findings from the trial are published in the Journal of American Medical Association.

Gestational diabetes is a global health issue affecting almost 3 million pregnant women worldwide every year. It is a condition characterized by elevated blood sugar levels during pregnancy, posing increased health risks for both mothers and their babies.

Fidelma Dunne, professor of medicine at the University of Galway and consultant endocrinologist at Saolta University Health Care Group, both in Galway, Ireland, managed the EMERGE randomized, placebo-controlled trial involving more than 500 pregnant women.

The study found that women who were assigned to metformin were 25% less likely to need insulin, and when insulin was necessary, it was started later in the pregnancy. Metformin is used routinely in the treatment of type 2 diabetes and has been widely available for over 60 years.

The study also found that fasting and postmeal sugar values in the mother were significantly lower in the metformin-exposed group at Weeks 32 and 38, and women receiving metformin gained less weight throughout the trial and maintained this weight difference at the 12-week postdelivery visit.

Importantly, delivery occurred at the same mean gestational age (39.1 weeks) in both groups. There was no evidence of any increase in preterm birth (defined as birth before 37 weeks) among those who received metformin. In addition, the study found that infants born to mothers who received metformin weighed, on average, 113 g less at birth, with significantly fewer infants classified as large at birth, or weighing over 4 kg (8 lb, 8 oz).

Other findings from the clinical trial include that while there was a slight reduction in infant length (0.7 cm), there were no other significant differences in baby measurements. There were slightly more babies who were small at birth, but this did not reach statistical significance. The study also revealed no differences in adverse neonatal outcomes, including the need for ICU treatment for newborns, respiratory support, jaundice, congenital anomalies, birth injuries, or low sugar levels. Additionally, there were no variations in rates of labor induction, cesarean delivery, maternal hemorrhage, infection, or blood pressure issues during or after birth.

Professor Dunne added, “The results from the EMERGE study are a significant step forward for women with gestational diabetes. Metformin has emerged as an effective alternative for managing gestational diabetes, offering new hope for expectant mothers and healthcare providers worldwide.”