Farmacie pro praxi. 2023;19(4):211-215

The role of metformin in the treatment of diabetes in pregnancy

Ondřej Krystyník

III. interní klinika - nefrologická, revmatologická a endokrinologická, Fakultní nemocnice a Lékařská fakulta Univerzity Palackého v Olomouci

Excelent metabolic control is essential for the successful course of pregnancy in women with both pregestational and gestational diabetes. However, in contrast to the non-pregnancy period, pharmacological options for the treatment of diabetes are limited. Compared with insulin, metformin offers a number of practical advantages, such as an oral route of administration, easy training and the low price. Although it crosses the placenta, its use is probably not associated with a risk of fetal harm in early pregnancy. Large randomized trials suggest several positive metabolic consequences of metformin use in pregnancy. These include lower maternal weight gain, lower incidence of hypertensive disorders in pregnant women, or fewer hypertrophic newborns. On the other hand, metformin is also associated with a possible risk of fetal growth restriction and preterm birth. Compared with insulin, metformin does not reduce the incidence of serious neonatal complications. Finally, the possible intrauterine influence on fetal metabolism, which may lead to an increased risk of metabolic disorders in later life in children, is being investigated.

Keywords: diabetes mellitus, gestational diabetes, pregnancy, metformin, insulin.

Accepted: November 23, 2023; Published: December 23, 2023  Show citation