Evidence map›Paper›PMID 39056256›Full record

ArticleThe Journal of clinical endocrinology and metabolism2025

Postnatal Cardiometabolic Health After Metformin Use in Gestational Diabetes: A Secondary Analysis of the EMERGE Trial.

Fidelma Dunne, Christine Newman, Alberto Alvarez-Iglesias, Paula O'Shea, Declan Devane, Paddy Gillespie, Aoife Egan, Martin O'Donnell, Andrew Smyth

Abstract read
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

9 authors.

Fidelma DunneInstitute for Clinical Trials, College of Medicine, Nursing and Health Sciences, University of Galway, Galway H91 TK33, Ireland.ORCID 0000-0003-3682-9403
Christine NewmanInstitute for Clinical Trials, College of Medicine, Nursing and Health Sciences, University of Galway, Galway H91 TK33, Ireland.ORCID 0000-0003-2387-4109
Alberto Alvarez-IglesiasHRB Clinical Research Facility Galway, University of Galway, Galway H91 TK33, Ireland.
Paula O'SheaHRB Clinical Research Facility Galway, University of Galway, Galway H91 TK33, Ireland.
Declan DevaneInstitute for Clinical Trials, College of Medicine, Nursing and Health Sciences, University of Galway, Galway H91 TK33, Ireland.
Paddy GillespieSchool of Business and Economics, University of Galway, Galway H91 TK33, Ireland.ORCID 0000-0001-6297-9478
Aoife EganInstitute for Clinical Trials, College of Medicine, Nursing and Health Sciences, University of Galway, Galway H91 TK33, Ireland.
Martin O'DonnellInstitute for Clinical Trials, College of Medicine, Nursing and Health Sciences, University of Galway, Galway H91 TK33, Ireland.
Andrew SmythInstitute for Clinical Trials, College of Medicine, Nursing and Health Sciences, University of Galway, Galway H91 TK33, Ireland.

Funding

Elucidating the Pathophysiology of Gestational Diabetes MellitusK23DK134767 · NIDDK · MAYO CLINIC ROCHESTER · PI Aoife Maria Egan · 2023 to 2026
$762k
AscensiaHealth Research Board of IrelandHRBHRB-Clinical Research Facility GalwayMerck Healthcare KGaANIDDK NIH HHS K23 DK134767
6 · The paper itself

Abstract

aimWomen with gestational diabetes mellitus (GDM) display adverse lifetime cardiometabolic health. We examined whether early metformin in GDM could impact cardiometabolic risk factors postpartum.

methodsEMERGE, a double-blind, placebo-controlled trial, randomized pregnancies 1:1 to placebo or metformin at GDM diagnosis and followed participants from randomization until 12 ± 4 weeks postpartum. In total, 478 pregnancies were available for postpartum maternal assessment, 237 and 241 assigned to metformin and placebo respectively. Weight (kg), body mass index (BMI) (kg/m2), waist circumference (cm), and blood pressure (mmHg) were measured, infant feeding method documented, and blood specimens drawn for a 75-gram oral glucose tolerance test, fasting insulin, C-peptide, and lipid analysis.

resultsDespite similar weight and BMI at trial randomization, participants receiving metformin had significantly lower weight (79.5 ± 15.9 vs 82.6 ± 16.9 kg; P = .04) and BMI (29.3 [5.6] vs 30.5 [5.4]; P = .018) at the postpartum visit. However, no difference in weight change from randomization to 12 weeks postpartum was observed between metformin and placebo groups. Overall, 29% (n = 139) of the cohort met criteria for prediabetes or diabetes, with no positive impact with metformin. There were also no differences in measurements of insulin resistance, blood pressure, or lipids between groups.

conclusionEarly metformin use in GDM did not impact important cardiometabolic parameters in the early postpartum period despite significant benefits in weight gain and insulin use in pregnancy.

Indexed as

Diabetes, GestationalHypoglycemic AgentsMetforminPostpartum PeriodAdultBlood GlucoseBlood PressureBody Mass IndexCardiometabolic Risk FactorsDouble-Blind MethodFemaleHumansPregnancyRandomized Controlled Trials as TopicSecondary Data AnalysisBlood GlucoseHypoglycemic AgentsMetformingestational diabetesmetforminpostpartum health

Identifiers

PMID39056256
PMCPMC12168073

What OpenQuestion holds

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Registered trials

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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.