Metformin or Insulin for Gestational Diabetes: Does It Matter in the Long Run?

Although insulin has been a therapeutic mainstay for gestational diabetes mellitus (GDM) refractory to dietary modification, use of oral hypoglycemic agents has risen markedly over the past decade because they are preferred by the vast majority of women. Metformin has attracted some interest as an alternative to the more commonly used glyburide; however, relatively little is known about metformin's long-term effects on prenatally exposed offspring. In a randomized, controlled trial of metformin versus insulin in 100 women with GDM, investigators in Finland assessed differences in offspring growth and development by 18 months of age.

By age 18 months, children exposed to metformin were taller and heavier (by a mean of 1.7 cm and 750.0 g, resp…