Insulin versus metformin (with or without supplementary insulin) in the control of gestational diabetes mellitus, A randomized control study.

Abstract

estational diabetes mellitus (GDM) is among the most frequent and most serious complications following pregnancy. In Egypt, there are approximately 2 million deliveries per year, therefore assuming a GDM incidence of at least 5% and a 50% rate of GDM women ending up on insulin, the rate of Egyptian GDM women needing insulin would be approximately 50 000 per year, causing a huge medical and economic burden. Fetal and neonatal complication of GDM including intrauterine fetal demise, congenital anomaly, fetal macrosomia, birth traumas, hypoglycemia, hyperbilirubinemia, respiratory distress, cardiomyopathy, hypocalcemia, prematurity, and pulmonary hyaline membrane disease. Further complications that may arise from GDM in later stages of childhood include metabolic syndrome and metabolic disorders, such as obesity, hypertension, dyslipidemia, and glucose intolerance. Maternal short‐term complications of GDM include increased chance of cesarean section, hyperglycemia crisis, urinary tract infections, and preeclampsia. Moreover, long‐term complications include predisposition to developing type 2 diabetes as well as cardiovascular disorders such as hyperlipidemia and hypertension.