Date of Award

2026

Document Type

Capstone

Degree Name

Master of Science (MS)

Department

Physician Assistant Studies

Committee Chair

Trey Boyd

Abstract

Intro: Gestational diabetes (GDM) is a condition in which pregnant women are unable to use insulin effectively, leading to increased levels of glucose in the body. Although insulin has traditionally been a first-line pharmacologic treatment for GDM, metformin is increasingly being explored as an alternative. The purpose of this clinical review is to analyze whether metformin could be a safe and effective oral antihyperglycemic option compared to insulin in the treatment of GDM.

Methods: PubMed was searched with a specific search strategy using the key terms “insulin,” “metformin,” “gestational diabetes,” and “blood glucose.” Operator and filters narrowed results to 19 relevant articles, and 4 quality articles were selected for review.

Results: Four studies evaluated the effect on HbA1c and glycemic control in pregnant women taking either metformin or insulin. Three of the studies also evaluated the outcomes of weight gain and preeclampsia in pregnant women taking metformin or insulin. All the studies evaluated neonatal outcomes. Three of the articles reviewed were meta-analyses or systematic reviews, and one was a randomized controlled trial.

Discussion: Overall, evidence shows that metformin was proven effective and safe in the short term for the treatment of gestational diabetes patients. Further investigation is needed to determine the long-term metabolic effects of metformin in children whose mothers were treated with metformin for GDM.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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