scholarly journals Effect of Maternal Metformin Treatment in Pregnancy on Neonatal Metabolism: Evidence From Newborn Metabolic Screening

Diabetes Care ◽  
2021 ◽  
pp. dc210327
Author(s):  
Jane Estrella ◽  
Veronica Wiley ◽  
David Simmons ◽  
Tien-Ming Hng ◽  
Mark McLean
Keyword(s):  
Metformin Treatment ◽  
Metabolic Screening ◽  
In Pregnancy

The effect of exercise and metformin treatment on circulating free DNA in pregnancy

Placenta ◽  
2014 ◽  
Vol 35 (12) ◽  
pp. 989-993 ◽  
Author(s):  
S.C. Christiansen ◽  
E. Vanky ◽  
H. Klungland ◽  
S.N. Stafne ◽  
S. Mørkved ◽  
...  
Keyword(s):  
Metformin Treatment ◽  
Circulating Free Dna ◽  
Free Dna ◽  
In Pregnancy

scholarly journals Effect of Maternal Metformin Treatment in Pregnancy on Neonatal Metabolism: Evidence From Newborn Metabolic Screening

2021 ◽  
Author(s):  
Jane Estrella ◽  
Veronica Wiley ◽  
David Simmons ◽  
Tien-Ming Hng ◽  
Mark McLean
Keyword(s):  
Normal Population ◽  
Vitamin B12 Deficiency ◽  
Maternal Diabetes ◽  
Exposed Group ◽  
Mass Spectrometry Data ◽  
Metformin Treatment ◽  
Retrospective Case ◽  
South Wales ◽  
Normal Controls ◽  
In Pregnancy

<b>Objective: </b>To investigate effects of maternal diabetes and metformin treatment on metabolic newborn screening (NBS) results of infants born to mothers with hyperglycemia during pregnancy <p><b>Research Design and Methods: </b> Retrospective case-control study. NBS results of infants born to mothers treated with metformin for hyperglycaemia during pregnancy were compared with diet-treated diabetes and matched normal controls. Exclusions: maternal type 1 diabetes, major fetal anomalies, incomplete infant data. Inclusions: maternal hyperglycemia in pregnancy treated with diet alone or diet plus metformin. Results from the New South Wales NBSP (dried infant bloodspot sample, 24-72 hours after birth) for 25 routinely studied analytes, were measured using mass spectrometry. Data from metformin-exposed and control infants were compared using non-parametric methods and multiples of the median for each analyte. </p> <p><b>Results: </b>574 cases were compared with 952 diet-treated diabetes cases and 979 controls. Metformin-exposed infants had shorter gestational age (266 days ±7 vs 272±10±34vs 274 ±9 ) (p= <0.001) and lower birth weights (3.28 kg ±0.51vs 3.29±0.49 ±0.52 vs 3.33±0.43) (p=0.008). Short, medium and one long-chain acylcarntine (tetradecanoylcarnitine; C14) concentrations were higher in the metformin exposed group compared to normal controls. Comparison with diet-treated diabetes controls (to eliminate confounding by hyperglycemia) continued to show raised butyrylcarntine (C4), isovalerylcarnitine (C5), glutarylcarnitine (C5D) in the metformin-exposed group. There was no evidence of vitamin B12 deficiency (low methionine, elevated propionylcarnitine; C3) in metformin-exposed infants. All results were within normal population limits. </p> <p><b>Conclusions: </b>We have identified subtle (non-pathological) changes in neonatal metabolism which represents a signature effect of fetal metformin exposure. </p>

scholarly journals Metformin treatment of type 2 diabetes mellitus in pregnancy: update on safety and efficacy

2018 ◽  
Vol 9 (6) ◽  
pp. 287-295 ◽  
Author(s):  
Thomas M. Polasek ◽  
Matthew P. Doogue ◽  
Tilenka R.J. Thynne
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pregnant Women ◽  
Product Information ◽  
First Trimester ◽  
Metformin Treatment ◽  
Childbearing Age ◽  
In Pregnancy

With the increasing prevalence of type 2 diabetes mellitus (T2DM) in women of childbearing age, prescribing antidiabetic medications in first-trimester pregnancy is becoming more common. Metformin treatment during this time is usually avoided in countries with well-resourced healthcare. This is based on historical concerns about safety to the foetus and the widespread availability of insulin. However, there is now increasing interest in the potential benefits of metformin in pregnant women with T2DM. In this commentary, the main evidence supporting metformin safety in pregnancy is summarized, with an emphasis on the first trimester. Based on a structured literature search, the recent randomized controlled trials comparing metformin and insulin are reviewed. We then show that prescribing advice for metformin in pregnancy is inconsistent and product information/package inserts (PI) are universally out of date. This causes confusion and pushes some women and their clinicians to change from metformin to insulin. The potential advantages of metformin in pregnant women with T2DM are then discussed, including oral dosing and improved acceptability, lower resource utilization and cost, decreased insulin requirements, less maternal weight gain and less risk of maternal and neonatal hypoglycaemia. The conclusion is that metformin is a cheap and efficacious antidiabetic medication for many pregnant women with T2DM, with reasonable evidence for safety. Drug information resources should be updated so that metformin can be considered more broadly in women with T2DM who present for antenatal care.

scholarly journals Metformin Treatment in Type 2 Diabetes in Pregnancy: An Active Controlled, Parallel-Group, Randomized, Open Label Study in Patients with Type 2 Diabetes in Pregnancy

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Jahan Ara Ainuddin ◽  
Nasim Karim ◽  
Sidra Zaheer ◽  
Syed Sanwer Ali ◽  
Anjum Ara Hasan
Keyword(s):  
Type 2 Diabetes ◽  
Treated Group ◽  
Metformin Treatment ◽  
Diabetes In Pregnancy ◽  
Open Label ◽  
Open Label Study ◽  
Label Study ◽  
Metformin Group ◽  
In Pregnancy

Aims.To assess the effect of metformin and to compare it with insulin treatment in patients with type 2 diabetes in pregnancy in terms of perinatal outcome, maternal complications, additional insulin requirement, and treatment acceptability.Methods.In this randomized, open label study, 206 patients with type 2 diabetes in pregnancy who met the eligibility criteria were selected from the antenatal clinics. Insulin was added to metformin treatment when required, to maintain the target glycemic control. The patients were followed up till delivery. Maternal, and perinatal outcomes and pharmacotherapeutic characteristics were recorded on a proforma.Results.Maternal characteristics were comparable in metformin and insulin treated group. 84.9% patients in metformin group required add-on insulin therapy at mean gestational age of 26.58 ± 3.85 weeks. Less maternal weight gain(P<0.001)and pregnancy induced hypertension(P=0.029)were observed in metformin treated group. Small for date babies were more in metformin group(P<0.01). Neonatal hypoglycemia was significantly less and so was NICU stay of >24 hours in metformin group(P<0.01). Significant reduction in cost of treatment was found in metformin group.Conclusion.Metformin alone or with add-on insulin is an effective and cheap treatment option for patients with type 2 diabetes in pregnancy. This trial is registered with clinical trial registration number: Clinical trials.govNCT01855763.

scholarly journals Effect of Maternal Metformin Treatment in Pregnancy on Neonatal Metabolism: Evidence From Newborn Metabolic Screening

2021 ◽  
Author(s):  
Jane Estrella ◽  
Veronica Wiley ◽  
David Simmons ◽  
Tien-Ming Hng ◽  
Mark McLean
Keyword(s):  
Normal Population ◽  
Vitamin B12 Deficiency ◽  
Maternal Diabetes ◽  
Exposed Group ◽  
Mass Spectrometry Data ◽  
Metformin Treatment ◽  
Retrospective Case ◽  
South Wales ◽  
Normal Controls ◽  
In Pregnancy

<b>Objective: </b>To investigate effects of maternal diabetes and metformin treatment on metabolic newborn screening (NBS) results of infants born to mothers with hyperglycemia during pregnancy <p><b>Research Design and Methods: </b> Retrospective case-control study. NBS results of infants born to mothers treated with metformin for hyperglycaemia during pregnancy were compared with diet-treated diabetes and matched normal controls. Exclusions: maternal type 1 diabetes, major fetal anomalies, incomplete infant data. Inclusions: maternal hyperglycemia in pregnancy treated with diet alone or diet plus metformin. Results from the New South Wales NBSP (dried infant bloodspot sample, 24-72 hours after birth) for 25 routinely studied analytes, were measured using mass spectrometry. Data from metformin-exposed and control infants were compared using non-parametric methods and multiples of the median for each analyte. </p> <p><b>Results: </b>574 cases were compared with 952 diet-treated diabetes cases and 979 controls. Metformin-exposed infants had shorter gestational age (266 days ±7 vs 272±10±34vs 274 ±9 ) (p= <0.001) and lower birth weights (3.28 kg ±0.51vs 3.29±0.49 ±0.52 vs 3.33±0.43) (p=0.008). Short, medium and one long-chain acylcarntine (tetradecanoylcarnitine; C14) concentrations were higher in the metformin exposed group compared to normal controls. Comparison with diet-treated diabetes controls (to eliminate confounding by hyperglycemia) continued to show raised butyrylcarntine (C4), isovalerylcarnitine (C5), glutarylcarnitine (C5D) in the metformin-exposed group. There was no evidence of vitamin B12 deficiency (low methionine, elevated propionylcarnitine; C3) in metformin-exposed infants. All results were within normal population limits. </p> <p><b>Conclusions: </b>We have identified subtle (non-pathological) changes in neonatal metabolism which represents a signature effect of fetal metformin exposure. </p>

Levetiracetam Induced Acute Pancreatitis Case in Pregnancy

2013 ◽  
Vol 40 (06) ◽  
pp. 896 ◽  
Author(s):  
Murat Sarikaya ◽  
Nesibe Taser ◽  
Zeynal Dogan ◽  
Bilal Ergul ◽  
F. Irsel Tezer ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
In Pregnancy
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