COMPARATIVE EFFICACY OF METFORMIN AND INSULIN IN THE TREATMENT OF GESTATIONAL DIABETES - A RANDOMISED CONTROL STUDY.

Abstract

AIMS AND OBJECTIVES: To compare the efcacy of insulin over metformin in the management of gestational diabetes mellitus and to compare maternal and foetal outcome in patients treated with Metformin and Insulin. : This was a hospital based randomised control study conductedMATERIALS AND METHODOLOGY over a period of 12 months from April 2020 to March 2021 amongst 104 pregnant women attending antenatal OPD of Department of Obstetrics and Gynaecology ,Guwahati medical college and hospital, Assam. Open label RCT Randomization process was used to randomize participants into Insulin and Metformin group. Maternal and foetal variables were followed up among both the groups and the results were compared. Metformin when compared with Insulin was showing similarRESULTS: efcacy and safety in terms of variables like Fasting and Post Prandial blood glucose control.Metformin signicantly reduces the incidence of polyhydramnios, fasting hypoglycaemia, post prandial hyperglycaemia and excessive weight gain during pregnancy. In the foetus, Metformin use was found to have reduced incidence of large for gestational age babies and indirectly preventing its related complications like need for LSCS, occurrence of shoulder dystocia at labour and neonatal hypoglycaemia. Insulin use in Gestational diabetes showed better neonatal outcome in terms of APGAR score and neonatal hypoglycaemia. But comparative efcacy of Insulin to Metformin in terms of post prandial blood glucose control was better, thus reducing the incidence of complications of poor glycaemic control in Gestational diabetes. ComparedCONCLUSION: with Insulin, Metformin also can be used as an effective treatment of Gestational Diabetes but efcacy of Insulin is more than Metformin in terms of maternal and foetal outcomes. Further larger trials are needed to conrm.