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Metformin Helps Prevent Gestational Diabetes in Women with Ovary Disease: Presented at AHA

By Jill Stein
Special to DG News

ANAHEIM, CA -- November 14, 2001 -- The use of metformin therapy throughout pregnancy in women with polycystic ovary syndrome (PCOS) significantly reduces the rate of onset of gestational diabetes.

This data was released at the annual meeting of the American Heart Association (AHA).

Dr. Charles Glueck, with the Jewish Hospital Cholesterol Center in Cincinnati, Ohio, conducted a study to determine whether the insulin-sensitizing drug metformin would reduce the development of gestational diabetes.

The study population included 33 non-diabetic women with well- documented PCOS who conceived while on metformin, 2.55 g/d, 28 of whom continued the drug through delivery (resulting in 34 live births) and in 35 non-diabetic women with PCOS with 53 live births without metformin.

Before metformin therapy, the women with PCOS were hyperinsulinemic, insulin resistant, and had high insulin secretion in response to insulin resistance.

Results showed that gestational diabetes developed in one (3 percent) of 33 pregnancies in the 33 women who conceived on metformin versus five (56 percent) of nine earlier pregnancies without metformin in those seven of 33 women who were able to conceive without metformin.

Gestational diabetes developed in 17 (32 percent) of 53 pregnancies in the cohort of 35 women with PCOS who conceived without metformin versus one (3 percent) of 33 in the 33 women with PCOS who conceived on metformin.

Without metformin, 32 to 56 percent of women with PCOS develop gestational diabetes with resulting worsening pregnancy outcomes, Dr. Glueck pointed out. Without metformin, gestational diabetes is common in women with PCOS partly because of their age. Specifically, women with PCOS tend to be older than women without PCOS because of infertility, he explained. Morbid obesity, hyperinsulinemia, and insulin resistance also increase the risk of gestational diabetes in women with PCOS.

Metformin is associated with a greater than tenfold decrease in gestational diabetes in women with PCOS. Dr. Glueck said. The medication works by reducing insulin resistance and insulin secretion, thereby lessening secretory demands imposed on pancreatic beta cells by both insulin resistance and pregnancy.

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