# Gestational weight gain according to treatment in gestational diabetes: a systematic review and meta-analysis

**Authors:** Carolina de Freitas Alves Amaral-Moreira, Daiane Sofia de Morais Paulino, José Paulo Siqueira Guida, Belmiro Gonçalves Pereira, Patrícia Moretti Rehder, Fernanda Garanhani Surita

PMC · DOI: 10.61622/rbgo/2025rbgo65 · Revista Brasileira de Ginecologia e Obstetrícia · 2025-09-08

## TL;DR

This study finds that pregnant women with diabetes who take metformin gain less weight during pregnancy compared to those using insulin.

## Contribution

The study provides a meta-analysis comparing gestational weight gain in gestational diabetes patients treated with metformin versus insulin.

## Key findings

- Gestational weight gain is lower with metformin compared to insulin treatment.
- Meta-analysis shows a standard mean difference of -1.05 in weight gain favoring oral medication over insulin.
- No significant differences were found in fetal birthweight or preeclampsia outcomes.

## Abstract

In this systematic review, we aim to compare the GWG in pregnant women with diabetes treated with metformin and other interventions

Data Sources: The searched baselines included PubMed, Scopus, Web of Science, Embase, and Virtual Health Library (BVS). Study selection: We selected articles that compared the GWG in women with diabetes treated with metformin or insulin. We have included clinical trials (randomized or not), observational studies (cohort, case control, and cross-sectional). Reviews (systematic or not), posters, event abstracts, and letters were excluded. Data Collection: We pooled odds ratios (OR) and mean difference (MD) and used a random effect model using R Studio software to compare the weight gain, fetal birthweight and preeclampsia according to treatment.

On research conducted in January 2024, with no data limit of the search, 433 trials were identified, of which 175 remained after duplicate removal. 50 studies were analyzed in the full text analyses and 9 were selected for the systematic review. 8 studies demonstrated that gestational weight gain during metformin treatment is lower when compared to other treatments, especially insulin, although it was not different from other outcomes. Meta-analyses demonstrated that oral medication GWG is lower than insulin with a standard mean difference (SMD) -1,05 [-1,87, - 0,23].

Oral medication has a lower gestational weight gain in patients with gestational diabetes when compared to insulin.

CRD 42024492158

## Linked entities

- **Chemicals:** metformin (PubChem CID 4091), insulin (PubChem CID 70678557)
- **Diseases:** gestational diabetes (MONDO:0005406)

## Full-text entities

- **Genes:** INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}
- **Diseases:** gestational diabetes (MESH:D016640), preeclampsia (MESH:D011225), diabetes (MESH:D003920), weight gain (MESH:D015430)
- **Chemicals:** GWG (-), metformin (MESH:D008687)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12520727/full.md

## References

25 references — full list in the complete paper: https://tomesphere.com/paper/PMC12520727/full.md

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Source: https://tomesphere.com/paper/PMC12520727