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Insulin is the preferred agent for managing type 2 diabetes during pregnancy, because the safety profile of metformin, which crosses the placenta, is unclear. Uncertainty about long-term effects of in utero metformin exposure on childhood growth limits its use in pregnant women; in fact, research has suggested that such exposure might promote childhood obesity. In a previously published study of neonatal outcomes, researchers randomized pregnant women with type 2 diabetes to insulin alone or insulin plus metformin (NEJM JW Womens Health Nov 2020 and Lancet Diabetes Endocrinol 2020; 8:834). Now, researchers have evaluated postnatal growth during follow-up of 283 infants from this study.
At 2 years of age, children who had been exposed to metf…