Marjan Mohammadnuri - Pediatrician , Assistant professor , Pediatric Department ,Tehran Medical sciences Branch , Islamic Azad University , Tehran , Iran

Background and Aim : Insulin has been a conventional medication in the treatment of female patients suffering from gestational diabetes mellitus (GDM) . However, the need for a large number of insulin injections in these patients causes them a lot of discomforts . The purpose of this study was to compare the effect of metformin and insulin with diet in regulating neonatal blood glucose level. Methods : In this clinical trial 90 women with gestational diabetes were included in the study. They were divided in two groups of 45 with metformin + insulin and diet. Blood glucose was measured using the German Richter glucometer 2017 model in the early morning fast from the first neonate nutrition and finally the neonatal blood glucose level was determined and compared. Data analysis was performed using SPSS software and statistical tests were Kolmogorov-Smirnov Shapirwilk Mann Whitney and Chi-square at the significant level of 0.05 .Results : The study population were from 18 – 33 years with mean age of 26.18 years . 20 (44%) of insulin + metformin group and 22 (28.9%) diet group were girls . History of GDM reported in 9 (20% ) diet group and 8 (17.8%) of insulin + metformin group . The mean neonatal blood glucose levels in the diet and insulin + metformin group were reported to be 53.6 , and 48.9 mg/dl respectively and showed significant different (p=0.006). The prevalence of neonatal hypoglycemia in the diet group was 11% (n=5)and in the insulin + metformin group reported 28.9%. Chi-square test showed significant differences , and the prevalence of neonatal hypoglycemia in the diet group was significantly lower than in the control group (P=0.03) . However, the two groups did not differ in the incidence of preeclampsia and macrosomia (P> 0.5).Conclusion : It seems that diet can be recommended as an effective substitute for insulin and metformin in the treatment of GDM . However , there are still some undesirable risk factors with both treatments that may threaten the mother and newborn.

Gestational diabetes mellitus , neonatal hypoglycemia , insulin , metformin