The Feasibility Of Metformin In The Treatment Of Gestational Diabetes Mellitus:A Meta-analysis

Objective :Aimed to explore the feasibility of metformin for the treat ment of gestational diabetes mellitus by evaluating the safety and efficiency of metformin in the treatment of gestational diabetes mellitus.Methods:Randomized controlled trials of metformin vs insulin in the t reatment of gestational diabetes mellitus were performed in Pubmed,Cochr ane-Library,Medline,and Embase databases.Statistical analysis was perfor med using Stata12.0 analysis software.Results: Fourteen randomized controlled trials(a total of 3057patients)were included in the study.Among them,1506 were treated with metformin and 1551 were treated with insulin.In total,359 patients(23.8%)in the metformin group required insulin to control blood glucose.The results showed that metformin did not increase the risk of preterm delivery(RR = 1.07,95% CI(0.77,1.47),P = 0.698),and could reduce the incidence of hypertension and preeclampsia during pregnancy(RR = 0.59,95% CI(0.39,0.91),P = 0.018),(RR = 0.67,95% CI(0.47,0.95),P =0.025),the mother glycosylated hemoglobin(HbA1c)after 36 weeks ofpregnancy in the metformin group was lower than that in the insulin group(WMD =-0.06,95% CI(-0.11,-0.01),P = 0.012),metformin can also reduce the incidence of neonatal hypoglycemia(RR = 0.65,95% CI(0.48,0.89),P = 0.008),and reduce mother 's weight gain(WMD =-0.93,95% CI(-1.36,-0.50),P = 0.00).There were no statistically significant differences in the remaining observation indicators between the experimental group and the control group.Conclusion: Metformin is feasible for the treatment of gestational diabetes,but more researches are needed to further determine the long-term feasibility of metformin in the treatment of gestational diabetes.