A Comparative Study of Maternal and Perinatal Outcomes in Gestational Diabetes Mellitus Treated with Metformin versus Insulin

Abstract

Background: Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders complicating pregnancy and is associated with adverse maternal and neonatal outcomes. Insulin has traditionally been the standard treatment for GDM; however, oral metformin has emerged as an effective alternative because of its ease of administration, lower cost, and better patient compliance.

Aim:  To compare the maternal and neonatal outcomes among women with gestational diabetes mellitus treated with metformin versus insulin therapy.

Materials and Methods: This prospective comparative observational study was conducted in the Department of Obstetrics and Gynecology of a tertiary care teaching hospital. A total of 50 pregnant women diagnosed with GDM were included and divided into two groups: metformin group (n=25) and insulin group (n=25). Maternal demographic characteristics, glycemic control, maternal complications, mode of delivery, and neonatal outcomes were assessed and compared between the groups. Statistical analysis was performed using SPSS software, and a p-value <0.05 was considered statistically significant.

Results: The baseline characteristics were comparable between the two groups. Adequate glycemic control was achieved in 84% of women in the metformin group and 92% in the insulin group. Cesarean section rates were higher in the insulin group (48%) compared to the metformin group (36%). Neonatal hypoglycemia, macrosomia, respiratory distress, and NICU admissions were more frequently observed in the insulin group. However, the differences were not statistically significant.

Conclusion: Metformin demonstrated comparable efficacy to insulin in achieving glycemic control in gestational diabetes mellitus with relatively favorable maternal and neonatal outcomes. Metformin may be considered a safe, effective, and convenient alternative to insulin therapy in selected women with GDM.