A recent study presented at the Endocrine Society’s ENDO 24 annual meeting concluded that the oral diabetes medication metformin is as safe for babies and their pregnant mothers as using insulin. The research tracked 10,117 children-mother pairs for up to 11 years postpartum and found that metformin and insulin can be used together to manage blood glucose levels during pregnancy. While GLP-1 medications are not yet approved for pregnancy, metformin and insulin have been used for decades.
Metformin, a non-insulin diabetes medication, has been prescribed for over 60 years, including during pregnancy. Unlike insulin, metformin cannot cause hypoglycemia and is simpler to use with less risk of weight gain. However, long-term effects on children born to mothers taking metformin have been less studied. Research from the Center for Endocrinology, Diabetes, Arthritis & Rheumatism in India compared the health outcomes of children and mothers using metformin or insulin to manage type 2 diabetes during pregnancy.
The study found no increase in factors like obesity and diabetes rates in children born to mothers taking metformin during pregnancy. This is significant as obesity rates among women have been rising, increasing the risk of type 2 diabetes during or after pregnancy. High blood glucose levels during pregnancy can lead to complications such as preeclampsia, birth defects, premature birth, and stillbirth. Finding safe and effective diabetes management strategies during pregnancy is critical for the health of both mother and baby.
Registered dietitian Jennifer Smith, coauthor of “Pregnancy with Type 1 Diabetes,” emphasizes that the choice between metformin and insulin should be based on individual factors beyond the diabetes diagnosis. Metformin is a gentler option that may be suitable for women who have made lifestyle changes but need additional support. Insulin and metformin work differently, with insulin helping cells use glucose and metformin reducing liver glucose release and increasing insulin sensitivity. Both medications can be used together for better blood glucose control during pregnancy.
Smith advises against switching from insulin to metformin if a woman was already on insulin before conception. Insulin may still be necessary throughout pregnancy, with metformin added to improve blood glucose management. Managing diabetes during pregnancy is challenging and requires dedication, but finding the right medication combination can help ensure a safe and healthy pregnancy for both mother and baby. The research on metformin’s safety during pregnancy provides valuable information for women with type 2 diabetes and healthcare providers.
