Maternal Weight Gain, BMI and HbA1c Levels In Women With Gestational Diabetes Mellitus Following Treatment With Metformin and Life Style Changes

Razia Iftikhar, Taqia Fouzia, Ziaullah Khan, Erum Ilyas, Naeeda Atif

Abstract

Objective

To find out the maternal outcomes (weight gain, BMI and HbA1c levels) in women with gestational diabetes mellitus treated with metformin along-with life style changes.

Study design

Quasi study.

Place & Duration of study

Department of Obstetrics & Gynecology, Sir Syed Hospital and Medical College Karachi, from September 2022  to August 2023.

Methods

Pregnant women gravida 1- 4, parity 1 - 4, with gestational diabetes mellitus (GDM) were included. Pregnant subjects with excessive weight gain in previous pregnancies, during current pregnancy, predominance of post prandial hyperglycemia, medical disorders like hypothyroidism, liver and kidney diseases, were excluded. GDM was diagnosed using WHO criteria. Women were guided about blood glucose monitoring and dietary intake. Life style changes were also advised. Metformin 500 mg orally was used as first line drug and the dose was titrated up to a maximum of 1500 mg. Data were entered into SPSS 23. Mean comparison of increase in weight, BMI and HbA1c levels from baseline to the 3rd trimester was done using Repeated Measure ANOVA. Mann Whitney U test was used to compare the response on weight gain with dosage of metformin. A p-value of < 0.05 were considered statistically significant.

Results

A total of 100 pregnant women were enrolled from the antenatal clinic. All the patients were in the first trimester of pregnancy. Mean age of the study subjects was 26.2±4.7 years, weight 54±8.4 Kg, BMI 22 ± 2.4 Kg/m2 and HbA1c 5.9 ± 0.3. All patients were followed till the third trimester. Effect of metformin and life style changes on weight gain, BMI and HbA1c levels during the pregnancy were statistically significant with p<0.05.  

Conclusion

Malformin therapy and lifestyle changes were found safe and effective to control the maternal weight, BMI and HbA1c levels during pregnancy.

Key words

Gestational diabetes mellitus, Maternal outcome, Pregnancy complications, Diabetes control.