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Fatema Chowdhury , Rajani Dube^*✉ , Roomiyah Riyaz , Karuna Khan , Shatha Taher Salman Al-Zuheiri , Imran Rashid Rangraze

1. Department of Obstetrics and Gynecology, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates.
2. Department of Obstetrics and Gynecology Abdulla Bin Omran Hospital, Ras Al Khaimah, United Arab Emirates.
3. Department of Internal Medicine, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates.

Abstract

Diabetes is the most common medical disorder in pregnancy in UAE affecting between 7.9% to 37.7% of women. Recommendations for Metformin use in pregnant diabetics vary between societies. Through this study, we explored the effectiveness and safety of metformin monotherapy in women with diabetes during pregnancy and analyzed the clinico-demographic profile of cases with successful metformin use. This is a retrospective study conducted in Abdulla Bin Omran Hospital, RAK between January 2018 and December 2019 including women with GDM and PGDM requiring pharmacological treatment for blood sugar control. The effectiveness of metformin was assessed with Glycemic control FBG, 1HPG, and 2HPG levels at definite intervals and pregnancy outcomes. Clinico-demographic profiles for the successful use of Metformin were analyzed. Descriptive, inferential, and regression model analyses were done by using SPSS version 24. This included 271 patients with GDM and 56 with PGDM(total 327).Metformin was as effective as insulin for the control of blood glucose in both GDM and PGDM. Insulin is more effective in control of FBG abnormalities but is associated with higher preterm labor rates(p=.0009).Women with higher BMI (≥40) and FBG levels at diagnosis are significantly more likely to need supplemental insulin(p= .00008 and .0001). This is not associated with factors like age, parity, ethnicity, class1 or class-2 obesity. There were no abnormalities or differences in babies at a 2-year follow-up. Metformin is a safe and effective option for both PGDM and GDM in carefully selected patients without any adverse effect on offspring‎.

Keywords: Metformin, Gestational diabetes, Pregestational diabetes, Monotherapy

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