Comparative analysis of fetomaternal outcome in women with gestational diabetes mellitus managed on different modalities

Abstract

Objectives: To compare fetomaternal outcome in women of gestational diabetes mellitus (GDM) managed on different modalities. Methods: A retrospective observational study was conducted in department of obstetrics and gynaecology at Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. All case records of 352 women with singleton pregnancy diagnosed with GDM in the hospital managed on different modalities, over a period of 18 month, were reviewed. Diagnosis of GDM was made according to guidelines of diabetes in pregnancy study group of India (DIPSI). They were divided into four groups, group A - MNT (medical nutrition therapy) (140 patients), group B - MNT plus metformin (90 patients), group C - MNT plus insulin (90 patients), group D - MNT plus metformin plus insulin (32 patients). Fetomaternal outcomes of GDM women managed on different modalities were recorded. Results: All the 4 groups of the patient in this study were demographically matched. There was no statistically significant difference in total weight gain during pregnancy (p = 0.6012), mode of delivery (p = 0.420), preterm delivery (p = 0.059), urinary tract infection (p = 0.387), hypertensive disorder in pregnancy (p = 0.773), and postpartum haemorrhage (p = 0.2656) between insulin v/s metformin group and MNT v/s metformin group. But incidence of polyhydramnios was significantly (p = 0.0230) higher in metformin group than in MNT group. Conclusion: Our study concluded that metformin seems to be an effective oral hypoglycemic drug in the treatment of GDM and does not appears to be associated with increased maternal and neonatal complications compared to insulin.

Keywords

• gestational diabetes mellitus
• medical nutrition therapy
• metformin
• insulin
• fetomaternal outcome