owens-markersofmetabolic-2013.pdf (1.02 MB)
Maternal and neonatal circulating markers of metabolic and cardiovascular risk in the metformin in gestational diabetes (MiG) trial: responses to maternal metformin versus insulin treatment
journal contribution
posted on 2013-03-01, 00:00 authored by Helen L Barrett, Kathryn L Gatford, Candice M Houda, Miles J De Blasio, H David McIntyre, Leonie K Callaway, Marloes Dekker Nitert, Suzette Coat, Julie OwensJulie Owens, William M Hague, Janet A RowanOBJECTIVE: This study was designed to compare glucose, lipids, and C-reactive protein (CRP) in women with gestational diabetes mellitus treated with metformin or insulin and in cord plasma of their offspring and to examine how these markers relate to infant size at birth. RESEARCH DESIGN AND METHODS: Women with gestational diabetes mellitus were randomly assigned to metformin or insulin in the Metformin in Gestational Diabetes trial. Fasting maternal plasma glucose, lipids, and CRP were measured at randomization, 36 weeks' gestation, and 6-8 weeks postpartum as well as in cord plasma. Women with available cord blood samples (metformin n = 236, insulin n = 242) were included. RESULTS: Maternal plasma triglycerides increased more from randomization to 36 weeks' gestation in women treated with metformin (21.93%) versus insulin (9.69%, P < 0.001). Maternal and cord plasma lipids, CRP, and neonatal anthropometry did not differ between treatments. In logistic regression analyses adjusted for confounders, the strongest associations with birth weight >90th centile were maternal triglycerides and measures of glucose control at 36 weeks. CONCLUSIONS: There were few differences in circulating maternal and neonatal markers of metabolic status and no differences in measures of anthropometry between the offspring of women treated with metformin and the offspring of women treated with insulin. There may be subtle effects of metformin on maternal lipid function, but the findings suggest that treating gestational diabetes mellitus with metformin does not adversely affect lipids or CRP in cord plasma or neonatal anthropometric measures.
History
Journal
Diabetes careVolume
36Issue
3Pagination
529 - 536Publisher
American Diabetes AssociationLocation
Arlington, Va.Publisher DOI
Link to full text
eISSN
1935-5548Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2013 by the American Diabetes AssociationUsage metrics
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AdultBlood GlucoseC-PeptideC-Reactive ProteinCardiovascular DiseasesCholesterol, HDLDiabetes, GestationalFemaleGlycated Hemoglobin AHumansHypoglycemic AgentsInfant, NewbornInsulinLeptinMetforminPregnancyRisk FactorsTriglyceridesScience & TechnologyLife Sciences & BiomedicineEndocrinology & MetabolismNEWBORN WEIGHTSERUM-LIPIDSMELLITUSWOMENFETALMACROSOMIATRIGLYCERIDETYPE-2HYPERGLYCEMIA
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