Evidence map›Paper›PMID 23020608›Full record

Trial reportDiabetes, obesity & metabolism2013

Metformin vs. insulin in gestational diabetes. A randomized study characterizing metformin patients needing additional insulin.

K Tertti, U Ekblad, P Koskinen, T Vahlberg, T Rönnemaa

Registry-linked trialAbstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Diabetes, obesity & metabolism, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02417090 (Metformin Therapy for Gestational Diabetes - Metabolic Late Effects on Child at 9 Years of Age), which is not on this map. Cited by 60 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 16 pooled it
9.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02417090 completedstarted 2015, after this paper: background citation

Metformin Therapy for Gestational Diabetes - Metabolic Late Effects on Child at 9 Years of Age

Ran2015Enrolled173Registered outcomes1Posted comparisons0ConditionsGestational DiabetesArmsInsulin, Metformin
PMID 21083860PMID 18795211other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 16 syntheses or guidelines pooled it, 188 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Evaluation of Preeclampsia Results after Use of Metformin in Gestation: Systematic Review and Meta-analysis.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2018
    Pooled it
  10. Insulin for the treatment of women with gestational diabetes.The Cochrane database of systematic reviews · 2017
    Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Pooled it
  16. Pooled it
  17. Trial
  18. Trial
  19. Trial
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

K TerttiDepartment of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland. kristiina.tertti@tyks.fi
U Ekblad
P Koskinen
T Vahlberg
T Rönnemaa
Turku University Hospital · FIUniversity of Turku · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsWe compared metformin with insulin as treatment of gestational diabetes mellitus (GDM). Furthermore, we aimed to characterize metformin-treated patients needing additional insulin to achieve prespecified glucose targets.

methodsWe conducted a single centre randomized controlled study with non-inferiority design comparing metformin and insulin in the treatment of 217 GDM patients having birth weight as primary outcome variable.

resultsThere were no significant differences in mean birth weight expressed in grams [+15 (90% confidence interval (CI): -121 to 89)] or SD units [+0.04 (90% CI: -0.27 to 0.18)] between the metformin and insulin groups. There were no significant differences in neonatal or maternal data between the groups. Only 23 (20.9%) of the 110 patients in the metformin group needed additional insulin. Compared with the patients on metformin only, those needing additional insulin were older (p = 0.04), their oral glucose tolerance test had been performed earlier and diabetes therapy started earlier in gestation (p = 0.01 and p = 0.004, respectively). The risk for additional insulin was 4.6-fold in women with baseline serum fructosamine concentration above median compared with those below median.

conclusionsMetformin is an effective alternative to insulin in the treatment of GDM patients. Serum fructosamine may help in predicting the adequacy of metformin treatment alone.

Indexed as

AdultBirth WeightBlood GlucoseDiabetes, GestationalDrug Administration ScheduleFemaleHumansHypoglycemic AgentsInsulinMaleMetforminPregnancyPregnancy OutcomeTreatment OutcomeBlood GlucoseHypoglycemic AgentsInsulinMetformin

Identifiers

PMID23020608
OpenAlexW2152958267

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.