Roy A, Sahoo J. Long-term effects of metformin use in gestational diabetes mellitus on offspring health. World J Diabetes 2021; 12(11): 1812-1817 [PMID: 34888009 DOI: 10.4239/wjd.v12.i11.1812]
Corresponding Author of This Article
Jayaprakash Sahoo, MBBS, MD, DM, Additional Professor, Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Room No. 5444, 4th floor, Puducherry 605006, India. jppgi@yahoo.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Nov 15, 2021; 12(11): 1812-1817 Published online Nov 15, 2021. doi: 10.4239/wjd.v12.i11.1812
Long-term effects of metformin use in gestational diabetes mellitus on offspring health
Ayan Roy, Jayaprakash Sahoo
Ayan Roy, Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Jodhpur 342005, Rajasthan, India
Jayaprakash Sahoo, Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
Author contributions: Sahoo J conceptualized the work; Roy A wrote the first draft; Roy A and Sahoo J edited the final draft with critical inputs; Both authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All authors have no conflicts of interest to report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jayaprakash Sahoo, MBBS, MD, DM, Additional Professor, Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Room No. 5444, 4th floor, Puducherry 605006, India. jppgi@yahoo.com
Received: March 21, 2021 Peer-review started: March 21, 2021 First decision: May 3, 2021 Revised: May 15, 2021 Accepted: October 3, 2021 Article in press: October 3, 2021 Published online: November 15, 2021
Abstract
Metformin is the first-line drug for the treatment of type 2 diabetes mellitus, but its role in gestational diabetes mellitus (GDM) management is not clear. Recent evidence suggests a certain beneficial effect of metformin in the treatment of GDM, but a high treatment failure rate leads to the initiation of additional medications, such as insulin. Moreover, since metformin crosses the placental barrier and reaches a significant level in the fetus, it is likely to influence the fetal metabolic milieu. The evidence indicates the long-term safety in children exposed to metformin in utero except for mild adverse anthropometric profiles. Diligent follow-up of metformin-exposed offspring is warranted from the clinician’s point of view.
Core Tip: The use of metformin in mild-to-moderate gestational diabetes mellitus may confer certain advantages. Since metformin reaches almost a similar serum level in the fetus, it is likely to influence the fetal metabolic environment. Limited long-term data suggest that metformin-exposed children have mild adverse anthropometric profiles. However, the clinical significance and effect on cardiometabolic health have yet to be determined.
