Comparison of Insulin, Metformin, and Diet Effect on Gestational Diabetes

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Bhavin Patel
October 16th, 2009
Bios 107
Comparison of Insulin, Metformin, and Diet Effect on Gestational Diabetes

RESEARCH ARTICLE: Rowan J., Gao W., Battin M., & Moore M. (2008). Metformin Vs. Insulin for the Treatment of Gestational Diabetes. The New England Journal of Medicine. 358(19):2003-2015. GENERAL ARTICLE: Abedin S. (2009). Study: Diet Can Help Avoid Diabetes Drugs. Time magazine.

Comparison of Insulin, Metformin, and Diet Effect on Gestational Diabetes Introduction
Diabetes is an epidemic disorder. Number of diabetes patients has increased very rapidly. Personally, I chose this topic because my major is Pharmacy. The other reason behind the selection of this topic is that there are millions of people in the world who are suffering from diabetes. The total number of diabetes patients in 2006 were 246 million and it is expected to reach up to 380 million in 2025 (Business Service Industry, 2007). There is not a single medicine or vaccine that can completely cure the diabetes. However, the insulin injections and other oral medicines are available in the market, but they are very expensive and they can maintain the blood glucose level temporarily. I notice that bitter melon has the same activity as insulin. I am going to do my research on diabetes in the future. I chose this topic for the research paper because this information might be very helpful to me in the future. Gestational diabetes is one type of diabetes which is diagnosed during the pregnancy. Hypoglycemia means a low blood sugar level. “Birth trauma” is a physical injury to the infants due to the mechanical forces during the pregnancy. Apgar score determines the newly born baby’s physical condition. Research Article

The researchers hypothesized that women would prefer to take metformin more rather than to take insulin for the treatment of gestational diabetes. Metformin, which is given orally, is an independent variable. The safety measurement of the mother and infant, during and after delivery in this experiment, is the dependent variable. Pregnant women are the test subjects in this experiment. Women who are receiving insulin during the treatment are the control group; women who are receiving metformin, sometimes followed by insulin, are the experimental group. Total number of women, age range, treatment time and testing methods are the same for both, control and experimental group.

The researchers conducted this research in the urban areas of New Zealand and Australia. They chose 751 women with gestational diabetes for this experiment. The women are divided into two groups. There are 363 women in the first group, who are treated with the metformin. The other group has 370 women and they are assigned to be given the insulin. All women are between 18 to 45 years of age. The women were on medication from the span time of 20 to 33 weeks. The enrollment of the women for this experiment started from October 2002 and ended in November 2006. The experiment was started after the completion of enrollment of women. Women who belonged to the first group were started with the 2500 mg dose of metformin and the second group women were started with 42 units of insulin. As the days passed, the doses of the drugs were increased. The researchers measured the safety of the mother and the infants for both drugs during the pregnancy period, and after the delivery of the baby.

The researchers observed the outcomes of the treatment. The complication of the infants did not differ in both drugs. The relative risk of the primary composite outcome was 32% of the 363 for the metformin assigned women and 32.2% for 370 for the insulin assigned women. Fifty-five infants born from the metformin treated women were hypoglycemic, while 69 infants born from the insulin treated women were hypoglycemic. Other complications like birth trauma, respiratory distress syndrome, and Apgar score were almost same for both drugs. Fourteen, 4% of 363, women had gestational...
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