Abid Naeem, Muhammad Shoaib, Sibtain-ul Hassan Abid.
Role of oral metformin and insulin therapy in management of Gestational Diabetes Mellitus.
Rawal Med J Jan ;44(2):269-71.

Objective: To assess the safety and efficacy of combinations therapy with insulin and metformin in gestational diabetes mellitus (GDM). Methodology: In this observational study, 147 pregnant women with GDM were included. All women were advised regular insulin therapy; metformin was added as they progressed to the second trimester. Fasting and random blood sugars were noted before starting therapy, and at the end of each trimester. Data were analyzed using SPSS v.17. Results: There were 63 (42.8%) women of age 20-30 years and 84 (57.1%) women of age 31-35 years. From baseline till term, FBS (mg/dl) decreased from 148, 135, 125, to 115 in younger age group and from 156, 151, 145, to 134 in the older age group. From baseline till term, RBS decreased from 416, 215, 194, to 118 in younger age group and from 458, 335, 245, to 161 in the older age group. Conclusion: Gestational diabetes was adequately managed in all women with combination of insulin and metformin. Addition of metformin improved glycemic control when insulin was insufficient alone; furthermore, its addition reduces the overall insulin requirement.

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