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Metformin versus insulin therapy for gestational diabetes: Effects on offspring anthropometrics and metabolism at the age of 9 years: A follow-up study of two open-label, randomized controlled trials

Tossavainen Päivi; Vääräsmäki Marja; Paavilainen Elisa; Nikkinen Hilkka; Loo Britt-Marie; Niinikoski Harri; Tertti Kristiina; Rönnemaa Tapio; Veijola Riitta

Metformin versus insulin therapy for gestational diabetes: Effects on offspring anthropometrics and metabolism at the age of 9 years: A follow-up study of two open-label, randomized controlled trials

Tossavainen Päivi
Vääräsmäki Marja
Paavilainen Elisa
Nikkinen Hilkka
Loo Britt-Marie
Niinikoski Harri
Tertti Kristiina
Rönnemaa Tapio
Veijola Riitta
Katso/Avaa
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Wiley-Blackwell
doi:10.1111/dom.14589
URI
https://doi.org/10.1111/dom.14589
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Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe2022012710921
Tiivistelmä

Aims
To compare anthropometrics, and lipid and glucose metabolism in the 9-year-old offspring of mothers treated with metformin or insulin for gestational diabetes mellitus (GDM).

Materials and Methods
This was a Finnish two-centre, 9-year follow-up study of two open-label, randomized controlled trials comparing the effects observed in the offspring of mothers who received metformin and insulin treatment for GDM. Measurements included anthropometrics, blood pressure, lipoproteins, and oral glucose tolerance tests. This study was registered with ClinicalTrials.gov, number NCT02417090.

Results
At the age of 9 years 172 children (55% of the original study cohort, 82 from the metformin and 90 from the insulin group) participated in the study. No differences were found between the 9-year-old offspring groups in anthropometric variables, including body mass index and waist-to-height ratio. The offspring in the metformin group had higher high-density lipoprotein (HDL) cholesterol concentrations (1.72 vs. 1.54 mmol/L; P = 0.039) but lower low-density lipoprotein cholesterol (2.39 vs. 2.58 mmol/L; P = 0.046) and apolipoprotein B concentrations (0.63 vs. 0.67 g/L; P = 0.043) than the offspring in the insulin group. The difference in HDL cholesterol concentration was found to be significant only in boys (P = 0.003). The 2-hour glucose value in the oral glucose tolerance test was 0.6-mmol/L lower in boys from the metformin group than in those from the insulin group (P = 0.015).

Conclusions
Metformin treatment for GDM is associated with similar offspring growth and glucose metabolism but a more favourable lipid profile at the age of 9 years as compared to insulin treatment.

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  • Rinnakkaistallenteet [19207]

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