Paavilainen, E, Tertti, K, Nikkinen, H, et al. Metformin versus insulin therapy for gestational diabetes: Effects on offspring anthropometrics and metabolism at the age of 9 years: A follow-up study of two open-label, randomized controlled trials. Diabetes Obes Metab. 2022; 24( 3): 402- 410. doi:10.1111/dom.14589
Metformin versus insulin therapy for gestational diabetes : effects on offspring anthropometrics and metabolism at the age of 9 years : a follow-up study of two open-label, randomized controlled trials
|Author:||Paavilainen, Elisa1; Tertti, Kristiina2; Nikkinen, Hilkka3;|
1Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
2Department of Obstetrics and Gynaecology, University of Turku and Turku University Hospital, Turku, Finland
3Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
4Department of Paediatrics, PEDEGO Research Unit, Medical Research Centre, University of Oulu and Oulu University Hospital, Oulu, Finland
5Joint Clinical Biochemistry Laboratory of University of Turku and Turku University Hospital, Turku, Finland
6Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
|Online Access:||PDF Full Text (PDF, 1 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2022031022791
John Wiley & Sons,
|Publish Date:|| 2022-03-10
Aims: To compare anthropometrics, and lipid and glucose metabolism in the 9-year-old offspring of mothers treated with metformin or insulin for gestational diabetes mellitus (GDM).
Materials and methods: This was a Finnish two-centre, 9-year follow-up study of two open-label, randomized controlled trials comparing the effects observed in the offspring of mothers who received metformin and insulin treatment for GDM. Measurements included anthropometrics, blood pressure, lipoproteins, and oral glucose tolerance tests. This study was registered with ClinicalTrials.gov, number NCT02417090.
Results: At the age of 9 years 172 children (55% of the original study cohort, 82 from the metformin and 90 from the insulin group) participated in the study. No differences were found between the 9-year-old offspring groups in anthropometric variables, including body mass index and waist-to-height ratio. The offspring in the metformin group had higher high-density lipoprotein (HDL) cholesterol concentrations (1.72 vs. 1.54 mmol/L; P = 0.039) but lower low-density lipoprotein cholesterol (2.39 vs. 2.58 mmol/L; P = 0.046) and apolipoprotein B concentrations (0.63 vs. 0.67 g/L; P = 0.043) than the offspring in the insulin group. The difference in HDL cholesterol concentration was found to be significant only in boys (P = 0.003). The 2-hour glucose value in the oral glucose tolerance test was 0.6-mmol/L lower in boys from the metformin group than in those from the insulin group (P = 0.015).
Conclusions: Metformin treatment for GDM is associated with similar offspring growth and glucose metabolism but a more favourable lipid profile at the age of 9 years as compared to insulin treatment.
Diabetes, obesity and metabolism
|Pages:||402 - 410|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3123 Gynaecology and paediatrics
Funding information: Diabetestutkimussäätiö; Lastentautien Tutkimussäätiö; Turun Yliopistollisen Keskussairaalan Koulutus- ja Tutkimussäätiö; Varsinais-Suomen Sairaanhoitopiiri; Yrjö Jahnssonin Säätiö
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2021 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.