Does Pregnancy Weight Gain Increase the Risk of Metformin Failure in the Treatment of Gestational Diabetes? [35D]. (May 2018)

• Record Type: Journal Article
• Authors: Persad, Malini D.; Ou, Jennie; Bernasko, James; Garry, David; Garretto, Diana; Herrera, Kimberly
• Is Part Of: Obstetrics and gynecology. Volume 131(2018)Supplement 1
• Publication Date: 2018-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000533014.92643.df
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: To determine if maternal weight gain is associated with a higher risk of metformin failure in women with gestational diabetes (GDM). METHODS: A retrospective cohort study of women with GDM was conducted from 2013-2016. Included in the study were women with GDM started on metformin after a failed trial of diet therapy. Excluded from the study were women with pre-existing diabetes mellitus. Women were categorized as having adequate glycemic control on metformin (metformin success) or requiring the addition of or transition to an insulin regimen (metformin failure). Metformin failure was defined as the inability to obtain glycemic control despite utilization of the maximum metformin dosage, or provider discretion. Maternal demographics and weight parameters were collected from the medical records and compared between the 2 groups. Parametric and nonparametric statistical analyses were performed with a p value of < 0.05 as statistically significant. RESULTS: A total of 146 women with GDM were identified, of which 21 women (14%) failed metformin therapy. There were no differences in maternal demographics. Although the overall weight gain in pregnancy was not statistically significant between the 2 groups, mothers who failed metformin therapy had significantly less weight gain from pre-pregnancy to GDM diagnosis and higher weight gain from GDM diagnosis to delivery compared to those who did not fail metformin therapy. CONCLUSION: Women who were successfully treated with metformin, gained less weight after GDM diagnosis. Providers should consider weight gain in pregnancy in counseling women regarding their risk of metformin failure in the treatment of GDM.