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Dr. Urvashi Chatterjee, Prof. Dr. Manasi Patnaik, Prof. Dr. Dayanidhi Meher, Dr Matcha Bala Priyanka
» doi: 10.31838/ecb/2023.12.si6.083


: For the past few decades, Insulin has been the first line of treatment for gestational diabetes mellitus. Even though Metformin is being increasingly used for the same, however sufficient data on its efficacy for glycaemic control, specially in high-risk ethnic groups is still lacking. Hence an unequal dichotomous opinion is observed in clinical practice. Objective: Our study aimed to compare glycaemic control achieved by insulin and metformin respectively, in women with gestational diabetes mellitus that were not controlled with 2 weeks of lifestyle changes and medical nutrition therapy. Materials and Methods: This study was an open labelled, randomised control trial carried out at a tertiary care centre in India. Women aged between 18 to 45 years, presenting within 24 to 28 weeks of gestational age, diagnosed as GDM were randomised into two groups to receive either insulin or metformin. The glycaemic control of the two groups were compared. This Study was conducted from September 2019 to June 2021 at Department of OBSTETRICS AND GYNAECOLOGY, PRADYUMNA BAL MEMORIAL HOSPITAL, KIMS, BBSR. Result: Between september 2019 and june 2021, 142 participants were recruited and 120 were randomised with 60 each in the insulin and metformin groups.Venous blood was used collected for laboratory blood glucose profile analysis. Analysis of Fasting Blood Plasma Glucose (FPG) and twohour postprandial glucose (2HPG) was done. Glycemic profile measurement included glycosylated hemoglobin (HbA1c) levels at enrollment and at 36-37weeks of period of gestation as well. Distribution of mean Capillary glucose level af overnight last 2 wk bf delivery with Group was not statistically significant (p=0.7826). .Distribution of mean 2-Hr capillary glucose last 2 wk before delivery with Group was not statistically significant (p=0.1095). Conclusion: The major problem of repeated injections of insulin could be solved with metformin, our study concluded that glycemic control in GDM can be achieved by using metformin orally as an alternative to insulin

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