Purpose of Review

To review the current evidence for the use of metformin in pregnancy for women with type 2 diabetes.

Recent Findings

A large, multicenter, double-blind randomized controlled trial found that women with type 2 diabetes in pregnancy treated with metformin as an adjunct to insulin therapy had less gestational weight gain, insulin requirements, caesarian sections, macrosomia, and neonatal adiposity, but more neonates were small for gestational age (SGA) compared with insulin alone. It is unclear if the higher number of SGA infants are a direct result of metformin exposure or mediated through other effects such as less gestational weight gain and improved glycemic control. Additional follow-up studies of offspring exposed to metformin in utero are required.

Summary

Metformin may be a useful adjunctive treatment for women with type 2 diabetes in pregnancy to help meet glycemic targets if there are no concerns for or indications of SGA.

中文翻译：

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二甲双胍在 2 型糖尿病女性妊娠中的应用：综述

审查目的

回顾目前在妊娠期使用二甲双胍治疗 2 型糖尿病女性的证据。

最近的发现

一项大型、多中心、双盲随机对照试验发现，妊娠期 2 型糖尿病女性接受二甲双胍作为胰岛素治疗的辅助治疗，其妊娠期体重增加、胰岛素需求、剖腹产、巨大儿和新生儿肥胖症较少，但新生儿较多与单独使用胰岛素相比，胎龄 (SGA) 较小。目前尚不清楚较高数量的 SGA 婴儿是二甲双胍暴露的直接结果还是通过其他影响介导的，例如妊娠期体重增加较少和血糖控制改善。需要对子宫内暴露于二甲双胍的后代进行额外的后续研究。

概括

如果没有 SGA 的担忧或适应症，二甲双胍可能是妊娠 2 型糖尿病女性的一种有用的辅助治疗，以帮助达到血糖目标。