The effect of metformin on perinatal outcomes in pregnant women with type 2 diabetes differs by baseline insulin requirements.
Am J Obstet GynecolMay 7, 2026 (epub)
Kevin S Shrestha, Claire E Jensen, Kim A Boggess et al.
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In 30 seconds
This randomized controlled trial analyzed the impact of metformin on perinatal outcomes in 785 pregnant women with type 2 diabetes, focusing on baseline insulin requirements. The study found that metformin significantly reduced the risk of composite adverse neonatal outcomes in women with a total daily insulin dose <30 U (44% vs 55%; adjusted relative risk, 0.76).
Key findings
- Metformin reduced the composite adverse neonatal outcome for insulin doses <30 U (44% vs 55%; adjusted relative risk, 0.76).
- No differences in neonatal outcomes were observed for insulin doses >60 U or >90 U.
- Metformin was associated with a smaller increase in insulin requirements for participants with doses >60 U and >90 U.
Why it matters
Understanding how metformin affects perinatal outcomes based on insulin requirements can guide clinicians in optimizing diabetes management during pregnancy, potentially improving maternal and neonatal health.