Pill effective against gestational diabetes

By Gene Emery

BOSTON (Reuters) - The diabetes pill metformin is just as effective as insulin injections in treating women who develop diabetes during pregnancy, researchers in New Zealand and Australia reported on Wednesday.

So-called gestational diabetes surfaces in one out of every 20 pregnant women, and there has been concern that metformin might affect a fetus because the drug can cross the placenta.

But the study, led by Janet Rowan of the Auckland City Hospital in New Zealand, found that the risk of complications such as respiratory distress, birth trauma and newborn hypoglycemia, or low blood sugar, was no different for the 363 women who received metformin and the 370 given conventional insulin shots.

Metformin is available generically but also known by the Bristol-Myers Squibb brand name Glucophage.

After delivery, nearly 77 percent of the metformin recipients said they would want to stay with the pill if they developed diabetes during pregnancy again, even though 46 percent still needed supplemental insulin injections at some point.

Only 27 percent of those who got insulin shots felt the same way, they reported in the New England Journal of Medicine.

But doctors may still be cautious, the researchers said. "Clinicians may remain circumspect about using metformin until follow-up data for offspring are available," they wrote. The children born during the study are being tested when they reach their second birthday.

In a commentary, Drs. Jeffrey Ecker and Michael Greene of Harvard Medical School in Boston say one remaining question is whether metformin would be better than another generic pill, glyburide.