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Infertility

Gestational Diabetes and Glucophage

12/22/2008

Question:

I am pregnant with my second child. During my first pregnancy my endocrinologist insisted that I re-start my glucophage as soon as I found out that I was pregnant. I have PCOS and insulin resistance. I threatened to lose the baby for almost 10 weeks. At 12 weeks I was taken off of the glucophage and watched very closely for Gestational Diabetes. I rode the line of fire for the entire pregnancy. I watched my carbs VERY closely and then had to incorporate exercise daily to keep my blood sugar levels at bay. I did not end up on insulin and in fact had a healthy baby weighing 7lb 13oz. Now I am expecting again and my new doctor wants to start me again on the glucophage immediately and is talking about trying to leave me on it longer than the 12 weeks. I do not know if I should go on it or attempt to just control it with diet and exercise again. And if I do go on it, why would I think that it would suddenly be safe to take for an extended period? Are there any new studies to suggest that taking glucophage long term is safe for a pregnancy now? Also, how do I know that taking the glucophage last time isn`t what made me start spotting and almost lose the baby?

Answer:

Answer Glucophage (metformin) is an oral medication used to treat some patient with adult-onset (type 2) diabetes. It is also used to treat women who have polycystic ovary syndrome (PCOS) and are having trouble getting pregnant because they do not ovulate regularly. It is not know to cause miscarriages and some studies suggest that it might decrease the risk of miscarriages in women with PCOS. Recent studies suggest that it can be used throughout pregnancy to help control blood glucose levels in some women. There appears to be little risk to the developing baby from taking metformin, which is currently classified as Class B in pregnancy. You should ask your obstetrician for more specific information about metformin and your particular situation.

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Response by:

William W Hurd, MD William W Hurd, MD
Professor of Reproductive Biology
School of Medicine
Case Western Reserve University