Vitamin B12 and homocysteine status during pregnancy in the metformin in gestational diabetes trial: responses to maternal metformin compared with insulin treatment

Gatford, K. L., Houda, C. M., Lu, Z. X., Coat, S., Baghurst, P. A., Owens, J. A., Sikaris, K., Rowan, J. A. and Hague, W. M. 2013, Vitamin B12 and homocysteine status during pregnancy in the metformin in gestational diabetes trial: responses to maternal metformin compared with insulin treatment, Diabetes, obesity and metabolism, vol. 15, no. 7, pp. 660-667, doi: 10.1111/dom.12080.


Title Vitamin B12 and homocysteine status during pregnancy in the metformin in gestational diabetes trial: responses to maternal metformin compared with insulin treatment
Author(s) Gatford, K. L.
Houda, C. M.
Lu, Z. X.
Coat, S.
Baghurst, P. A.
Owens, J. A.ORCID iD for Owens, J. A. orcid.org/0000-0002-7498-1353
Sikaris, K.
Rowan, J. A.
Hague, W. M.
Journal name Diabetes, obesity and metabolism
Volume number 15
Issue number 7
Start page 660
End page 667
Total pages 8
Publisher Wiley
Place of publication Chichester, Eng.
Publication date 2013-07
ISSN 1463-1326
Keyword(s) Adult
Biomarkers
Cohort Studies
Diabetes, Gestational
Female
Homocysteine
Humans
Hyperhomocysteinemia
Hypoglycemic Agents
Insulin
Metformin
Nutritional Status
Postpartum Period
Pregnancy
Pregnancy Complications
Pregnancy Trimester, Second
Pregnancy Trimester, Third
South Australia
Transcobalamins
Vitamin B 12
Vitamin B 12 Deficiency
Science & Technology
Life Sciences & Biomedicine
Endocrinology & Metabolism
GDM
vitamin B12
POLYCYSTIC-OVARY-SYNDROME
PLACEBO-CONTROLLED TRIAL
SERUM HOMOCYSTEINE
INCREASING PREVALENCE
TERM TREATMENT
RISK-FACTORS
MELLITUS
FOLATE
WOMEN
DEFICIENCY
Summary AIM: The aim of the study is to compare the effects of metformin and insulin treatment for gestational diabetes mellitus (GDM) on vitamin B12 and homocysteine (Hcy) status. METHODS: Women with GDM, who met criteria for insulin treatment, were randomly assigned to metformin (n = 89) or insulin (n = 91) in the Adelaide cohort of the metformin in gestational diabetes (MiG) trial. Fasting serum total vitamin B12 (TB12), holotranscobalamin (HoloTC), a marker of functional B12 status and plasma Hcy concentrations were measured at 20-34 weeks (at randomization) and 36 weeks gestation, then at 6-8 weeks postpartum. RESULTS: Circulating TB12, HoloTC and Hcy were similar in both treatment groups at each time point. Women who were taking dietary folate supplements at randomization had higher serum TB12 and HoloTC at randomization than those not taking folate. Overall, serum TB12 fell more between randomization and 36 weeks gestation in the metformin group than in the insulin group (metformin: -19.7 ± 4.7 pmol/l, insulin: -6.4 ± 3.6 pmol/l, p = 0.004). The decrease in serum TB12 during treatment was greater with increasing treatment duration in metformin-treated (p < 0.001), but not in insulin-treated women. CONCLUSIONS: Total, but not bioavailable, vitamin B12 stores were depleted during pregnancy to a greater extent in metformin-treated than in insulin-treated women with GDM, but neither analyte differed between groups at any stage. This adds further evidence supporting metformin as a safe alternative treatment to insulin in GDM. Further investigation is needed to evaluate whether women treated with metformin for longer periods in pregnancy require additional B12 or other supplementation.
Language eng
DOI 10.1111/dom.12080
Field of Research 1103 Clinical Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2013 Blackwell Publishing Ltd
Persistent URL http://hdl.handle.net/10536/DRO/DU:30116805

Document type: Journal Article
Collection: Office of the Deputy Vice-Chancellor (Research)
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