SynthesisActa diabetologica2023
Short-term neonatal outcomes in women with gestational diabetes treated using metformin versus insulin: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in Acta diabetologica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 4 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Comparison of pregnancy outcomes and physical conditions of infants in patients with gestational diabetes mellitus treated with metformin and insulin: a meta-analysis study.BMC pregnancy and childbirth · 2026Pooled it
- Metformin + Insulin vs. Insulin for GDM and T2DM during pregnancy: systematic review and meta-analysis.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2026 · on this mapPooled it
- Gestational weight gain according to treatment in gestational diabetes: a systematic review and meta-analysis.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2025Pooled it
- Metformin versus insulin in gestational diabetes mellitus: a systematic review.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2024Pooled it
- The Effect of Metformin on Insulin Requirement, Glycaemic Control and Weight Gain in Type 1 Diabetes During Pregnancy-a Randomised, Placebo-Controlled Multicentre Study.Diabetes/metabolism research and reviews · 2025Trial
- Lifestyle Behaviors, Physical Activity, and Body Composition in Women With Gestational Diabetes: A Real-World Observational Study From Poland.Medical science monitor : international medical journal of experimental and clinical research · 2026Observational
- Metformin use in gestational diabetes is not associated with an increased risk of preterm labor and small for gestational age infants compared to diet control alone.BMC pregnancy and childbirth · 2025Article
- A narrative review of metformin in pregnancy: Navigating benefit and uncertainty.Diabetes, obesity & metabolism · 2025Review
- Developing a Risk Stratification Tool to Predict Patients with Gestational Diabetes Mellitus at Risk of Insulin Treatment: A Cohort Study.Journal of personalized medicine · 2025Article
- Oral Glucose-Lowering Agents vs Insulin for Gestational Diabetes: A Randomized Clinical Trial.JAMA · 2025Article
- Metformin and risk of adverse pregnancy outcomes among pregnant women with gestational diabetes in the United Kingdom: A population-based cohort study.Diabetes, obesity & metabolism · 2025Article
- Metformin in polycystic ovary syndrome: unraveling multi-stage therapeutic mechanisms from puberty to long-term health outcomes.Frontiers in pharmacology · 2025Review
- Effects of metformin combined with insulin aspart on gestational weight gain, lipid metabolism, immune function, and delivery outcomes in pregnant women with gestational diabetes.American journal of translational research · 2025Article
- Maternal Fasting Plasma Glucose, Age and Body Mass Index as Prediction of Gestational Diabetes Mellitus in Iran.Iranian journal of public health · 2024Article
- Review
- Changes in Oxidative Stress and Intestinal Permeability during Pregnancy in Women with Gestational Diabetes Mellitus Treated with Metformin or Insulin and Healthy Controls: A Randomized Controlled Trial.Antioxidants (Basel, Switzerland) · 2023Article
- Case Report: Abruptio placentae and epileptic seizure after occurrence of perinatal hyperglycaemia in woman with gestational diabetes mellitus and hypertriglyceridemia-induced acute pancreatitis.Frontiers in endocrinology · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo expand the evidence base for the clinical use of metformin, we conducted a meta-analysis of randomized controlled trials (RCTs) comparing the efficacy and safety of metformin versus insulin with respect to short-term neonatal outcomes.
methodsA comprehensive search of electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) was performed. Two reviewers extracted the data and calculated pooled estimates by use of a random-effects model. In total, 24 studies involving 4355 participants met the eligibility criteria and were included in the quantitative analyses.
resultsUnlike insulin, metformin lowered neonatal birth weights (mean difference - 122.76 g; 95% confidence interval [CI] - 178.31, - 67.21; p < 0.0001), the risk of macrosomia (risk ratio [RR] 0.68; 95% CI 0.54, 0.86; p = 0.001), the incidence of neonatal intensive care unit admission (RR 0.73; 95% CI 0.61, 0.88; p = 0.0009), and the incidence of neonatal hypoglycemia (RR 0.65; 95% CI 0.52, 0.81; p = 0.0001). Subgroup analysis based on the maximum daily oral dose of metformin indicated that metformin-induced neonatal birth weight loss was independent of the oral dose.
conclusionsOur meta-analysis provides further evidence that metformin is a safe oral antihyperglycemic drug and has some benefits over insulin when used for the treatment of gestational diabetes, without an increased risk of short-term neonatal adverse outcomes. Metformin may be particularly useful in women with gestational diabetes at high risk for neonatal hypoglycemia, women who want to limit maternal and fetal weight gain, and women with an inability to afford or use insulin safely.
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Identifiers
What OpenQuestion holds
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.