Metformin in Pregnancy: An Option for Gestational Diabetes

Positive results using metformin while pregnant

Generally speaking, I am hesitant to put chemicals of any kind into my body - be it prescription drugs, over the counter pain killers, or foods with chemical preservatives/dyes, etc. However, after not being able to conceive a baby naturally and being diagnosed with PCOS, I was put on Glucophage (metformin) and became pregnant within 6 months. This was a little over two years ago, and the thinking at the time was that staying on the drug through the first 12 weeks reduced the chance of miscarriage dramatically. I did this, but was hesitant to go off after 12 weeks as things had been going well. My doctor authorized me to stay on until 20 weeks, at which point I went off the metformin. Within a month, I had developed full fledged gestational diabetes - common to those with PCOS even when controlling blood sugars with diet and exercise. I had to be on insulin the remainder of the pregnancy and the GD was poorly controlled regardless, they seemed not to be able to get the insulin dosage right - lots of highs and lows. Regardless, I gave birth to an extremely healthy, 8lb baby girl at just short of 40 weeks gestation. My daughter is now almost two years old and both physically (90th% for height, 65th% for weight) and intellectually (participated in an elective Bayley III IQ testing and was on average 90th% in all areas) doing fantastic. She is a well balanced, healthy and happy child. I think metformin plays a huge role in her being here today.

That said, I recently went back on metformin in hopes of conceiving again. My (new - we moved across the country) doctor put me on an extended release version of the drug and I still have not had a period after 4 months of use. My side effects are drastically different this time, as well. I am trying to get my doctor to prescribe the standard non-extended release pills again, and possibly go back to the brand name Glucophage instead of the generic metformin (which was the original formula that worked for me). Of course, all of the doctors here say it makes no difference, but - it worked before, so my hope is to go back to what worked. Regardless, my doctors agree this time that I should stay on the drug throughout the pregnancy, and based on my experience last time I am comfortable doing so. Hopefully we'll get this current glitch fixed, but at least previously my experiences remaining on the drug for a little more than half the pregnancy were very positive.

pregnant and a type 2 diabetic!

My concerns is that the meds. they are trying to give me might harm my baby. Like metformin and insulin. Everyone I talk to told me that I should not take metformin. Im really scared I have had to miscarrages before one was because of the meds I was on for diabetes. I really want my baby, and for my baby and I to be healthy. I also have two other children that need me too. Im just really scared and worried. Someone please let me know what to do or there opinion!

Normal?

I became a diabetic last May. My last 2 previous pregnancies (12 and 8 years ago) I was only a gestational diabetic, with my first child I had no gestational diabetes (14 years ago) with my second I had diet controlled gestational diabetes and many birth complications. My third pregnancy I was put on insulin and had a wonderful pregnancy/delivery. Now 8 years later (surprise!) and a full fledged diabetic (diet, exercise, Metformin) I am expecting again. My doctor has decided to keep me on Metformin 500CR as well as put me on insulin in which I have had to increase my insulin dose the further along in my pregnancy I become. I keep asking him if he is sure if it is safe for the baby. He tells me I can keep taking it until 12 hours before my delivery because of the concern I expressed to him about breast feeding and Metfomin use. Originally I wanted to drop the Metformin and go totally on insulin but from what I've been reading, it sounds like that would be a bad idea even though I did have a great previous pregnancy on insulin only (although I wasn't a diabetic before the pregnancy.

Metformin during pregnancy

Thank you for your research into this issue. The information provided is quite useful. I am 9 wks pregnant and conceived with the aid of Metformin...my concern is going into a state of "rebound" should I discontinue it.

My first pregnancy was not treated with any medications. the gestational diabetes was controlled with only diet.

Unfortunately my baby was born with multiple congenital defect such as bilateral cateracts, and poor motor skills etc. She eventually passed on 9 mths later.

i am type 2 diabetic and i take metformin

i was just reading these things and now im a little worried. my doctor didnt say anything to me about the risk of taking this oral contraceptive, so im just asking if it is alright or not cause if not then i want off of it right now .............please let me know

Metformin in Pregnancy: An Option for Gestational Diabetes

Thank you for your thoughtful article about the recent study published in the New England Journal of Medicine, of which I am a co-author.

I would like to point out that we have clearly shown that metformin does indeed cross the placenta, as mentioned and referenced in the paper. In a study of 23 babies whose mothers had been taking metformin during pregnancy, metformin was found in the cord blood at about 60% of the concentration of that found in the mothers.

Given that the offspring in the recent study whose mothers had taken metformin had less severe hypoglycemia than the offspring of mothers treated with insulin alone, it is possible that there may be an effect on insulin action in the fetus that is beneficial. Follow-up studies of the offspring and their mothers from the trial population in the third year after birth are underway, and further longer term studies are planned.

Meanwhile, as Dr Coustan rightly points out, it is a matter of judgment whether or not to use metformin in pregnant women with diabetes. Previous studies published in the same Journal (Crowther et al 2005) have clearly shown that treatment of women with gestational diabetes with lifestyle adjustments +/- insulin is beneficial for both offspring and mother. We expect that many will be reassured by the results of our study, and be prepared to take/use metformin as an alternative to insulin. But there is as yet no therapeutic imperative to do so.