Metformin During Pregnancy And Breastfeeding
Tweet People with diabetes who become pregnant often need to understand how to manage their diabetes during pregnancy. Similarly, those who develop gestational diabetes need to know how medication such as Metformin can affect them. Is Metformin suitable for women who are breastfeeding? During pregnancy, control of diabetes is often achieved using insulin, as this provides stable blood glucose levels. Some medicines should not be used during pregnancy or breastfeeding. If you are pregnant, or are planning a pregnancy, always inform your doctor before using any medicine, including Metformin. The manufacturer of Metformin advises people with diabetes not to take this medicine whilst pregnant. So is Metformin safe during pregnancy? The National Institute for Clinical Excellence advise that metformin is both safe and effective during pregnancy. For those women with type 2 diabetes who were taking Metformin before pregnancy, it is considered safe. However, this should be discussed with your doctor. What about Metformin and breastfeeding? Metformin, like many medications, may pass into breast milk in very small quantities. NICE also recommend that taking Metformin is safe during breastfeeding. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic Continue reading >>
Original Article The Role Of Continuing Metformin Therapy During Pregnancy In The Reduction Of Gestational Diabetes And Improving Pregnancy Outcomes In Women With Polycystic Ovary Syndrome
Abstract To evaluate the value of continuing metformin therapy in women with PCOS throughout pregnancy and its role in reducing the development of gestational diabetes and improving pregnancy outcome by reducing spontaneous miscarriage rate. Fifty-seven infertile cases with polycystic ovary syndrome who became pregnant were classified into two groups: group 1 included 31 cases who conceived while taking metformin therapy with or without other ovulation inducing agents and continued metformin during pregnancy in a dose of 1000–1500 mg daily and group 2 included 26 cases who conceived without taking metformin and did not take it during pregnancy. Maternal outcome measures including; assessment of insulin resistance, incidence of gestational diabetes mellitus, the need for insulin therapy and incidence of preeclampsia. Fetal outcome measures include incidence of, spontaneous miscarriage, preterm birth, fetal growth abnormalities, suspected fetal asphyxia at birth, fetal anomalies and neonatal mortality. The incidence of gestational diabetes mellitus was significantly lower in cases who received metformin than those who did not receive metformin during pregnancy (3.2% versus 23.08%, respectively), and spontaneous miscarriage occurred in one case (3.2%) in patients who continued metformin compared to 7 cases (26.9%) in patients who did not take metformin. No significant differences between both groups in other outcome measures. Continuous metformin therapy throughout pregnancy in women with PCOS improves pregnancy outcomes by decreasing spontaneous miscarriage rates and prevention of gestational diabetes mellitus with its co morbidity and mortality. Continue reading >>
Can Metformin Help Women With Pcos?
Home / Fertility / Boosting Fertility We asked doctors whether the drug Metformin really helps women with PCOS conceive, reduce miscarriage risk and increase milk supply. Here's what they say. If you have polycystic ovary syndrome (PCOS), you're not alone. According to the National Center for Biotechnology Information , this hormonal disorder affects between 5 percent and 15 percent of women of reproductive age in this country. In polycystic ovary syndrome, cysts develop on the ovaries, and the body produces excess hormones called androgens, which cause an irregular menstrual cycle. As a result, ovulation can be unpredictable, and getting pregnant can be challenging. "Since puberty, I've averaged one menstrual cycle per year," says Carrie, a mother from the Midwest who has PCOS. "I always wondered if I could have children." Carrie tried getting pregnant for several months, but wasn't able to because she wasn't ovulating. After evaluating her bloodwork, her OB/GYN suggested she go on either Clomid or Metformin to help balance her hormones to promote ovulation. "Because I had a very slight imbalance in my hormones, my doctor suggested trying Metformin before going straight to Clomid. Since I heard horror stories about Clomid causing multiples, I was happy to try Metformin first," Carrie says. Metformin is a diabetes medication that is sometimes used to regulate hormones in women with PCOS by balancing their insulin level. This effect leads to more regular menstruation and ovulation cycles , according to WebMD . Carrie got pregnant the first month she took Metformin. But not all women with polycystic ovary syndrome have such good results. In fact, experts say more evidence is needed to prove that Metformin helps conception in PCOS patients . "When putting all the data tog Continue reading >>
Is It Dangerous To Take Metformin While Pregnant?
Is it Dangerous to Take Metformin While Pregnant? Metformin is among the most prescribed medications in the world. It is commonly used as the first-in-line treatment for type 2 diabetes but is also used to treat polycystic ovarian syndrome, pre-diabetes, and gestational diabetes. Researchers conducted a study to assess the risk of taking metformin if pregnant. Researchers gathered a cohort of women exposed to metformin during their first trimester for various reasons and compared them to a reference group of women not exposed to metformin during pregnancy. They found that the risk of major birth defects was just 5% in pregnancies exposed to metformin during the first trimester and 2% in the reference group. Of the group taking metformin, the risk was 7.8% in patients with pre-gestational diabetes and 1.7% in those without pre-gestational diabetes. The risk of pregnancy losses which include stillbirths and spontaneous abortions was 20.8% in women taking metformin during the first trimester and 10.8% in the reference group. Women taking metformin with pre-gestational diabetes had a 24% risk while those without pre-gestational diabetes taking metformin had a 16.8% risk when compared to the reference group. The researchers conclude in their study abstract that Pregnant women with pre-gestational diabetes on metformin are at a higher risk for adverse pregnancy outcomes than the general population. This appears to be due to the underlying diabetes since women on metformin for other indications do not present meaningfully increased risks. In other words, the higher risk seems to be attributed to the pre-gestational diabetes and not the metformin. Have you been pregnant while taking metformin? Continue reading >>
Metformin Use During The First Trimester Of Pregnancy
Go to: First-trimester exposure The Motherisk Program recently conducted a retrospective cohort study on pregnancy outcome among women with PCOS15 and a meta-analysis of all published studies with data on pregnancy outcomes with respect to major malformations.16 In the retrospective cohort study, 72 PCOS patients exposed to metformin were compared with 48 PCOS patients who conceived without metformin in five different fertility clinics. The prevalence of major malformations was similar in the two groups. The metformin group had a higher prevalence of multiple pregnancies and prematurity. Prematurity is a substantial confounder of concomitant use of other fertility drugs.15 Results of the meta-analysis are encouraging. In the five studies included in the statistical analysis, there was no increase in the rate of major malformations, and in fact, metformin might actually have a protective effect in women with PCOS. In the treated group, there were three malformations among 172 babies (1.7%); in the control group, there were 17 malformations among 235 babies (7.2%). The odds ratio was 0.50 in favour of treatment.16 In summary, no evidence currently in the literature shows that use of metformin in women with PCOS is associated with increased risk of malformations. Most of the studies applicable to PCOS restricted exposure to the first trimester, ie, metformin was discontinued as soon as pregnancy was diagnosed. Evidence beyond the first trimester is anecdotal at this point. Large well-controlled studies of humans are needed. For women with non–insulin-dependent diabetes mellitus, insulin is still considered the treatment of choice during pregnancy, although glyburide has been shown not to cross the human placenta.17,18 Motherisk questions are prepared by the Motherisk Tea Continue reading >>
Metformin For Gestational Diabetes - What It Is And How It Works
In the UK it is common to use Metformin for gestational diabetes where dietary and lifestyle changes are not enough to lower and stabilise blood sugar levels. It is widely used to help lower fasting blood sugar levels as well as post meal levels. Metformin is an oral medication in tablet form. It is used in diabetics to help the body use insulin better by increasing how well the insulin works. In pregnancy it can be used in women who have diabetes before becoming pregnant (Type 2 diabetes) and in women who develop diabetes during pregnancy (gestational diabetes). Metformin is also used for other conditions too, commonly used in those that have PCOS (polycystic ovarian syndrome). Metformin is a slow release medication. Here are the most commonly asked Q&A on Metformin for gestational diabetes from our Facebook support group Why do I need to take Metformin? For many ladies with gestational or type 2 diabetes, if lower blood sugar levels cannot be reached through diet and exercise then medication will be required to assist. If blood sugar levels remain high, then the diabetes is not controlled and can cause major complications with the pregnancy and baby. Some consultants will prescribe Metformin on diagnosis of gestational diabetes on the basis of your GTT results. Others will let you try diet control first and when blood glucose levels rise out of target range, or close to the target range, they may prescribe Metformin as a way to help lower and control your levels. NICE guidelines regarding the timing and use of Metformin for gestational diabetes 1.2.19 Offer a trial of changes in diet and exercise to women with gestational diabetes who have a fasting plasma glucose level below 7 mmol/litre at diagnosis. [new 2015] 1.2.20 Offer metformin to women with gestational dia Continue reading >>
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- Glibenclamide and metfoRmin versus stAndard care in gEstational diabeteS (GRACES): a feasibility open label randomised trial
- Metformin in Gestational Diabetes
Effects Of Metformin Use In Pregnant Patients With Polycystic Ovary Syndrome
Go to: REVIEW OF LITERATURE In a randomized, placebo-controlled, double blind study, done on 257 pregnant women with PCOS, aged 18 - 42 years, who either received metformin or placebo from first trimester to delivery, failed to demonstrate any reduction of pregnancy-related complications, such as gestational diabetes, pre-eclampsia and pre-term delivery in the metformin group. On the contrary, a prospective study done on 98 pregnant women with PCOS who received metformin (1700 – 3000 mg/day) before conception and up to 37 weeks of pregnancy vs. 110 normal pregnant controls, showed a significant reduction of pregnancy complications, such as gestational diabetes and gestational hypertension but an insignificant decrease in pre-eclampsia incidence with comparable mean neonatal Apgar scores, weight and length between the 2 groups. Metformin has been shown to have encouraging effects on several metabolic aspects of polycystic ovarian syndrome, such as insulin sensitivity, plasma glucose concentration, and lipid profile and since women with PCOS are more likely than healthy women to suffer from pregnancy-related problems like early pregnancy loss, gestational diabetes mellitus and hypertensive states in pregnancy, the use of metformin therapy in these patients throughout pregnancy may have beneficial effects on early pregnancy loss and development of gestational diabetes. However, there is little evidence of its beneficial effect on hypertensive complications in pregnancy. In a 3-year case controlled study, conducted on 197 pregnant women with PCOS (confirmed by Rotterdam criteria), in which cases comprised of women who continued metformin throughout pregnancy while controls were women who stopped metformin after the first trimester, it was concluded that in compar Continue reading >>
Effects Of Metformin On Early Pregnancy Loss In The Polycystic Ovary Syndrome
Polycystic ovary syndrome is the most common form of female infertility in the United States. In addition to poor conception rates, pregnancy loss rates are high (30–50%) during the first trimester. We hypothesized that hyperinsulinemic insulin resistance contributes to early pregnancy loss in the syndrome, and that decreasing hyperinsulinemic insulin resistance with metformin during pregnancy would reduce the rate of early pregnancy loss. We conducted a retrospective study of all women with polycystic ovary syndrome who were seen in an academic endocrinology clinic within the past 4.5 yr and who became pregnant during that time. Sixty-five women received metformin during pregnancy (metformin group) and 31women did not (control group). The early pregnancy loss rate in the metformin group was 8.8% (6 of 68 pregnancies), as compared with 41.9% (13 of 31 pregnancies) in the control group (P < 0.001). In the subset of women in each group with a prior history of miscarriage, the early pregnancy loss rate was 11.1% (4 of 36 pregnancies) in the metformin group, as compared with 58.3% (7 of 12 pregnancies) in the control group (P = 0.002). Metformin administration during pregnancy reduces first-trimester pregnancy loss in women with the polycystic ovary syndrome. Suppression of spermatogenesis to azoospermia is the goal of hormonal male contraception based on T combined with gestagens. The combination of the long-acting T, ester testosterone undecanoate (TU), with norethisterone (NET) enanthate (E) showed high efficacy. In the present study, we tested the validity of this approach by varying the NET dose and mode of application. The aim of the study was to achieve high rates of suppression of spermatogenesis as reflected by sperm counts, monitor gonadotropins as well as other Continue reading >>
Metformin And Pregnancy
In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. This sheet talks about whether exposure to metformin may increase the risk for birth defects over that background risk. This information should not take the place of medical care and advice from your health care provider. What is metformin? Metformin is an oral medication used to treat type 2 diabetes and insulin resistance in polycystic ovarian syndrome (PCOS). Other names for this medication include GlucophageÂ®, DiforminÂ®, GlumetzaÂ®, FORTAMETÂ® and GlyconÂ®. I use metformin for the treatment of type 2 diabetes. Should I stop metformin before I get pregnant? Before and during pregnancy, blood sugar levels should be under control to prevent a higher chance of birth defects and complications. Insulin is usually the medication of choice because it controls blood sugar more tightly than oral medications. However, metformin has also been used to treat type 2 diabetes in pregnant women when insulin alone provides only partial blood sugar control. Please consult your health care before pregnancy to determine which medication(s) is/are the most appropriate for you. For more information about diabetes during pregnancy, please see the MotherToBaby fact sheet Diabetes and Pregnancy at If you become pregnant while using metformin, you should not stop your medication without first talking to your health care provider. I am taking metformin to treat PCOS. Should I stop taking the medication before and/or after I get pregnant? You should not stop any medication without first talking with your health care provider. Studies have indicated that women with PCOS who are treated with metformin have a better chance of getting pregnant. Some studies Continue reading >>
How Long Does It Take For Metformin To Work For Conception?
Metformin, also known as Glucophage, is a medication that is used to regulate the levels of glucose (sugar) in the blood. Metformin accomplishes its task through three methods. First, it causes the liver to produce less glucose. Second, metformin helps your stomach to absorb less glucose from the food that you eat. Finally, metformin improves the efficiency of the insulin that the body produces, which reduces the amount of glucose that is in your blood. Metformin is often prescribed for people with Type II diabetes. How long it takes Metformin to work depends on the reason that a woman is taking metformin. If a woman is taking metformin to regulate her blood sugar, metformin typically will work within a few days or a few weeks at the most. For the woman with polycystic ovarian syndrome (PCOS) metformin can help to reduce the amount of insulin in the body. Once the insulin levels are under control, many women will then experience improved ovulation. If metformin is going to work for a woman who has experienced fertility problems because of her polycystic ovarian syndrome, it will typically help within three to six months. Unlike most fertility treatments, metformin does not cause a risk of having a multiple or twin pregnancy. If metformin alone does not help a woman with PCOS who is trying to conceive, a fertility doctor may prescribe Clomid, as well. If metformin is prescribed for a woman with PCOS to help restore a regular, normal menstrual cycle, metformin can work within 4 to 8 weeks. In addition, the stabilized levels of insulin may affect the other hormones in a woman’s body, and reduce other symptoms of PCOS. Some women, either with diabetes or PCOS, use metformin as a tool for weight loss. If this is the case, weight loss can occur somewhere between 1 and 5 wee Continue reading >>
Metformin Therapy During Pregnancy
Type 2 diabetes and gestational diabetes mellitus (GDM) are closely related disorders characterized by increased insulin resistance. Metformin, a biguanide compound, exerts its clinical effect by both reducing hepatic glucose output and by increasing insulin sensitivity. This results in a decreased glucose level without an associated high risk of either hypoglycemia or weight gain. These characteristics have established metformin as an ideal first-line treatment for people with type 2 diabetes and, hypothetically, a particularly attractive drug for use in pregnancy. However, metformin is known to cross the placenta (1,2), and its use in pregnancy has been limited by concerns regarding potential adverse effects on both the mother and the fetus. Historically, some of the earliest reports of the use of metformin during pregnancy have come from South Africa, where it has been used since the late 1970s for women with both type 2 diabetes and GDM (3–6). While perinatal mortality for these women was still higher than that seen in the general obstetric population, it was nonetheless lower than in women who had gone untreated and similar to those who were changed to insulin. No “headline” adverse events or side effects were reported. Confidence regarding the use of metformin in pregnancy has been reinforced by the results of several observational studies and randomized trials over the past decade. Two meta-analyses of observational studies—one of women using metformin and/or sulphonylureas and one of women using metformin alone during the first trimester—did not show an increase in congenital malformations or neonatal deaths (7,8). While increased perinatal mortality and pre-eclampsia was noted in one study of 50 women with type 2 diabetes using metformin, these result Continue reading >>
Is It Safe To Use Metformin During Pregnancy?
Metformin is a commonly used drug for managing type 2 diabetes. It is considered an effective treatment option for many people with diabetes, but is it safe for pregnant women? Metformin is a drug that helps to lower blood sugar. It is considered one of the best first line treatments for type 2 diabetes. A review posted to Diabetology & Metabolic Syndrome notes that metformin helps to lower blood sugar levels, strengthens the endocrine system, improves insulin resistance, and reduces fat distribution in the body. Before taking any drugs, including metformin, a pregnant woman has to be absolutely sure that the drugs will not affect her or her baby. Effects of metformin use during and after pregnancy Some people are concerned about using metformin during and after pregnancy because it crosses the placenta. This means that when a pregnant woman takes metformin, so does her baby. However, the results of the few studies that have been carried out so far into the effects of taking metformin during pregnancy have been positive. A 2014 review posted to Human Reproduction Update found that the drug did not cause birth defects, complications, or diseases. The researchers did note, however, that larger studies should be carried out to make this evidence more conclusive. Metformin and gestational diabetes A separate review posted to Human Reproduction Update noted that women who took metformin to treat gestational diabetes (diabetes during pregnancy) gained less weight than women who took insulin. A 2-year follow-up study found that babies born to the women treated with metformin had less fat around their organs, which could make them less prone to insulin resistance later in life. This could mean that children who are exposed to metformin at a young age could gain long-term benefi Continue reading >>
Is Metformin Safe For Use During Pregnancy?
Metformin: is it safe during pregnancy? Metformin is an oral medication that has been prescribed to treat type 2 diabetes for 60 years. For more than 40 years, it has been used during pregnancy. However, the question of whether metformin should be taken during the later months of pregnancy is a subject of ongoing debate. That’s because the long-term effects on the fetus are not known. Women may take metformin during pregnancy for a variety of reasons: before becoming pregnant to treat type 2 diabetes, to treat infertility issues caused by polycystic ovary syndrome (PCOS), or to control gestational diabetes. “Very early in pregnancy, approximately the first 10 weeks, unhealthy blood glucose levels can cause birth defects, so we want to keep blood glucose levels as close to normal range as possible so malformations don’t occur,” says Mary R. Loeken, Ph.D., Research Investigator, Section on Islet Cell and Regenerative Biology at Joslin Diabetes Center. “This window of time is when the organ systems are forming and the embryo is susceptible to malformations.” On the other hand, high blood glucose levels later in pregnancy can cause complications for the mother, such as hypertension or preeclampsia, and impact the birth weight of the baby. In a scientific review published in the September issue of Diabetologia, Dr. Loeken reviewed what is known about the effects of metformin used at different stages of pregnancy on the embryo or fetus. As a basic science researcher, her aim is to understand the molecular and cellular processes of metformin at the different stages of prenatal development. She explained that metformin turns on an enzyme known as AMP-activated protein kinase (AMPK), altering cellular activity. In mouse models, this AMPK activity contributes to conge Continue reading >>
Metformin Use During Pregnancy
A 31-year-old woman with polycystic ovarian syndrome and metabolic syndrome has been treated with metformin 500 mg twice daily until now; she is in the 8th week of her first pregnancy. Would it be recommended that she continue taking metformin throughout pregnancy or discontinue? What is the risk of the fetal damage caused by metformin? What is the risk of pregnancy loss caused by insulin resistance? Response from Peter S. Bernstein, MD, MPH, FACOG and Esther Schmuel, MD Polycystic ovarian syndrome (PCOS) occurs in 5% to 7% of reproductive-age women and is diagnosed if at least 2 of the following criteria are present: (1) oligo-ovulation or anovulation (often appearing as oligomenorrhea or amenorrhea), (2) elevated levels of androgens (total or free testosterone, androstendione), (3) clinical manifestations of hyperandrogenism (acne, hirsutism, male-pattern baldness), and (4) polycystic appearance of ovaries on ultrasound. Approximately 30% to 40% of women with PCOS have impaired glucose tolerance, and as many as 10% will develop diabetes by the fourth decade. Women with PCOS are also more insulin resistant than similar age- and weight-matched controls.[ 1 , 2 ] Metformin is an oral biguanide that is approved for the treatment of non-insulin-dependent diabetes. Metformin acts primarily by decreasing hepatic glucose production, as well as by decreasing intestinal absorption of glucose and increasing peripheral uptake and utilization of glucose. In patients with PCOS, it reduces fasting insulin, basal and stimulated luteinizing hormone (LH) levels, and free testosterone concentrations.[ 3 ] The role of metformin in ovulation induction is well established, and several studies have demonstrated that women with PCOS are more likely to ovulate with metformin than with placeb Continue reading >>
Should I Continue My Metformin In Early Pregnancy?
Metformin is a drug that is often prescribed, off-label, for the treatment of PCOS and for regulating ovulation. It belongs to a class of drugs that improves the cells' response to insulin and regulates blood sugar. An off-label prescription means that the FDA has not approved the use of a drug specifically for that condition. In this case, metformin has been approved for the treatment of diabetes but not for PCOS specifically. How Metformin Works Because so many women with PCOS also have insulin resistance and diabetes, it is believed that treating the insulin dysfunction might have an effect on the other hormonal irregularities associated with the condition. While researchers aren’t sure of the exact mechanism, there is some evidence that backs up this theory: some studies have shown that women who take a combination of metformin and clomid (a drug that is used to induce ovulation in anovulatory women) have a better response to the medication regimen than those who take clomid alone. Some women with PCOS, especially those that are insulin resistant, may see more regular periods from taking metformin as well. Metformin Dosage Dosages of between 1,500 mg to 2,000 mg daily are typical, depending on a woman's insulin resistance and risks of side effects. Many women taking metformin report having stomach upset, nausea and diarrhea — especially with higher doses. The doctor may recommend slowly increasing your dosage until you reach the prescribed dosage to increase your tolerance to the drug. Other physicians will recommend the extended release form, meaning that a small amount of the medication is released throughout the day, instead of all at once like with a regular release pill. It is important to take your medication exactly as prescribed and let your doctor kn Continue reading >>