CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2018; 40(04): 180-187
DOI: 10.1055/s-0038-1642632
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Effectiveness of Metformin in the Prevention of Gestational Diabetes Mellitus in Obese Pregnant Women

Efetividade da metformina na prevenção do diabetes mellitus gestacional em gestantes obesas
Willian Barbosa Sales
1   Universidade da Região de Joinville, Jonville, SC, Brazil
,
Iramar Baptistella do Nascimento
1   Universidade da Região de Joinville, Jonville, SC, Brazil
,
Guilherme Dienstmann
1   Universidade da Região de Joinville, Jonville, SC, Brazil
,
Matheus Leite Ramos de Souza
2   Department of Medicine, Universidade da Região de Joinville, Jonville, SC, Brazil
,
Grazielle Dutra da Silva
2   Department of Medicine, Universidade da Região de Joinville, Jonville, SC, Brazil
,
Jean Carl Silva
1   Universidade da Região de Joinville, Jonville, SC, Brazil
› Author Affiliations
Further Information

Publication History

02 December 2017

06 March 2018

Publication Date:
27 April 2018 (online)

Abstract

Objective To assess the effectiveness of metformin in the incidence of gestational diabetes mellitus (GDM) in obese pregnant women attending a public maternity hospital in Joinville, Santa Catarina, Brazil.

Methods Randomized clinical trial including obese pregnant women with a body mass index (BMI) ≥ 30 kg/m2, divided into two groups (control and metformin). Both groups received guidance regarding diet and physical exercise. The participants were assessed at two moments, the first at enrollment (gestational age ≤ 20) and the second at gestational weeks 24–28. The outcomes assessed were BMI and gestational diabetes mellitus (GDM) diagnosis. The data distribution was assessed with the Friedman test. For all the analytical models, the p-values were considered significant when lower than 0.05. The absolute risk reduction was also estimated.

Results Overall, 164 pregnant women were assessed and further divided into 82 participants per group. No significant difference was observed in BMI variation between the control and metformin groups (0.9 ± 1.2 versus 1.0 ± 0.9, respectively, p = 0.63). Gestational diabetes mellitus was diagnosed in 15.9% (n = 13) of the patients allocated to the metformin group and 19.5% (n = 16) of those in the control group (p = 0.683). The absolute risk reduction was 3.6 (95% confidence interval 8.0–15.32) in the group treated with metformin, which was not significant.

Conclusion Metformin was not effective in reducing BMI and preventing GDM in obese pregnant women.

Resumo

Objetivo Avaliar a efetividade da metformina na incidência de diabetes mellitus gestacional (DMG) em gestantes obesas de uma maternidade pública de Joinville, Santa Catarina, Brasil.

Métodos Ensaio clínico randomizado desenvolvido com gestantes obesas com índice de massa corporal (IMC) ≥ 30 kg/m2, divididas em dois grupos (controle e metformina). Ambos os grupos receberam orientação sobre dieta e exercício físico. As participantes foram avaliadas em dois momentos, o primeiro na inclusão (com idade gestacional ≤ 20 semanas) e o segundo entre 24 e 28 semanas de gestação. Os desfechos avaliados foram IMC e diagnóstico de diabetes mellitus gestacional (DMG). A distribuição dos dados foi avaliada com o teste de Friedman. Para todos os modelos analíticos, foram considerados significativos os valores de p inferiores a 0,05. Foi estimada também a redução absoluta de risco.

Resultados Foram avaliadas 164 gestantes, divididas em 82 participantes em cada grupo. Não houve diferença significativa na variação do IMC entre os grupos controle e metformina (0,9 ± 1,2 versus 1,0 ± 0,9, respectivamente, p = 0,63). O DMG foi diagnosticado em 15,9% (n = 13) das pacientes alocadas para o grupo metformina e 19,5% (n = 16) das incluídas no grupo controle (p = 0,683). A redução absoluta de risco foi de 3,6 (intervalo de confiança de 95% 8,0–15,32) no grupo metformina, o que não foi significativo.

Conclusão A metformina não foi eficaz em reduzir o IMC e prevenir o DMG em gestantes obesas.

Contributors

Sales W. B., Nascimento I. B., Dienstmann G., Souza M. L. R. and Silva G. D. have contributed with the project conception, analysis, and interpretation of data. Sales WB, Silva JC. Contributed with final approval of the version to be published: Sales W. B., Nascimento I. B., Dienstmann G., Souza M. L. R., Silva G. D., Silva J. C. have contributed with critical review of the intellectual content.


 
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