Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynaecology and Obstetrics

Objectives: To determine whether the addition of metformin to a standard regimen of insulin is more effective inglycemic control, and better fetal and neonatal outcome thanconventional insulin alone in uncontrolled diabetic patients during the 3 {u036C} {u0369} trimester of pregnancy. Methods:This study was conducted in high risk pregnancy unit at kasr Al Ainy hospital and concluded one hundred and fifty patients recruited and randomized into two groups. Each group includedseventy five patients. Group A patients received insulin only and group Breceived insulin plus metformin (in the form of 1000 mg twice daily after meals).All were uncontrolled diabetic patients in the 3 {u036C} {u0369} trimester ofpregnancy. No reported side effects such as gastrointestinal upset or lactic acidosis were recorded.Results:Statistically significant differences were found between both groups as regards maternal glycemic control being better in group B (metformin plus insulin) Neonatal hypoglycemia, weight and admission to NICU>24hours was lower in group B. Apgar score was better in group B (metformin plus insulin). Conclusion:Addition of metformin to insulin in uncontrolled diabetic patients may be helpful in improving maternal glycemic control and decreasing neonatal hypoglycemia, birth weight and decrease NICU admission>24hrs. Also it may improve neonatal Apgar scor

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