WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Dr. Yusra Yousif Najm and Dr. Ghadah Salah Abdulrazzaq

ABSTRACT

Background: GDM is an endocrine disorder affecting mothers and fetuses, causing insulin resistance, disruptingnutrient metabolism, and decreasing insulin sensitivity. It is often prescribed as a second-line medication afterinsulin. Aim: To assess the maternal and perinatal outcomes between the women managed for gestational diabetesby Metformin in relation to insulin. Methodology: A cohort study at Al-Khansaa Teaching Hospital involved 226pregnant women with gestational diabetes, divided into two groups: 127 treated with metformin and 99 withinsulin therapy. Patients were given individualized dietary advice and home blood glucose monitoring. Inadequateglycaemic control was identified in patients with three or more tests higher than target values within a two-weekperiod. Treatment options were discussed, with metformin being contraindicated in certain cases. Results: Thestudy compared baseline characteristics between Metformin and insulin groups, finding no significant differences.Metformin had lower HbA1c levels, higher BMI at early pregnancy, and no significant differences in familyhistory. Induction of labor was performed in 11.0% and 26.3% of Metformin and insulin groups, respectively.Total cesarean section was lower in Metformin (23.6%) compared to insulin (36.4%). Postnatal OGTT glucoseshowed no significant difference at fasting, but abnormal postnatal glucose tests were found in 7.1% of Metforminand 21.2% of insulin groups. No significant differences were found in perinatal outcomes. Conclusion:Metformin treatment significantly improved labor induction, caesarean delivery, postnatal OGTT glucose, andreduced jaundice requiring phototherapy in women compared to insulin treatment.