{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:38:39Z","timestamp":1793119119935,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,9,7]],"date-time":"2018-09-07T00:00:00Z","timestamp":1536278400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004748","name":"Mashhad University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004748","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Cellular Physiology"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Insulin has been a conventional medication in the treatment of female patients suffering from gestational diabetes mellitus (GDM). However, the need for a large number of insulin injections in these patients causes them a lot of discomforts. Recently, an alternative medication, metformin, has received considerable attention in the treatment of GDM. The aim of this study was to compare the efficacy of metformin and insulin in regulating blood glucose levels and fetal outcomes in GDM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This randomized clinical trial included 286 pregnant women diagnosed with positive GDM at 24\u201328 weeks of pregnancy. The subjects were randomly divided into two groups of 143 patients, with one group receiving insulin and the other undergoing a treatment plan using metformin. Fasting plasma glucose (FPG), 2\u2010hr plasma glucose (PG) and glycated hemoglobin (HbA1c) were recorded twice a month until delivery. Other variables, including birth delivery method, cause of cesarean section, gestational age at the delivery time, birth trauma, Apgar score, birth weight, admission at neonatal intensive care unit (NICU), and neonatal hypoglycemia were also registered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Age of mother, body mass index, history of diabetes in the family, previous history of GDM, parity, FPG, 1\u2010 and 2\u2010hr PG after meals, and 75\u2010g glucose tolerance test before treatment were not statistically different between the two groups. FPG,\u00a0PG, and HbA1c did not show significant differences between the two groups after completing the course of treatment. There was also no significant difference between two groups regarding the birth delivery method, the cause of cesarean section, birth trauma, Apgar score, birth weight, admission at NICU, and neonatal hypoglycemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>As mean FPG and 2\u2010hr PG were not significantly different between the two groups, it seems that metformin can be recommended as an effective substitute for insulin in the treatment of GDM. However, there are still some undesirable risk factors with both treatments that may threaten the mother and the newborn.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcp.27238","type":"journal-article","created":{"date-parts":[[2018,9,7]],"date-time":"2018-09-07T09:54:54Z","timestamp":1536314094000},"page":"4695-4701","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["The efficacy of metformin compared with insulin in regulating blood glucose levels during gestational diabetes mellitus: A randomized clinical trial"],"prefix":"10.1002","volume":"234","author":[{"given":"Nayereh","family":"Ghomian","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Medicine, Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyede Houra Mousavi","family":"Vahed","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Medicine, Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samaneh","family":"Firouz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Medicine, Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Ali","family":"Yaghoubi","sequence":"additional","affiliation":[{"name":"Birjand University of Medical Sciences Birjand Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masoud","family":"Mohebbi","sequence":"additional","affiliation":[{"name":"Metabolic Syndrome Research Center, Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8656-1444","authenticated-orcid":false,"given":"Amirhossein","family":"Sahebkar","sequence":"additional","affiliation":[{"name":"Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences Mashhad Iran"},{"name":"Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences Mashhad Iran"},{"name":"School of Pharmacy, Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,7]]},"reference":[{"key":"e_1_2_8_1_2_1","unstructured":"American Diabetes Association.Standards of medical care in diabetes.Diabetes Care41(Suppl 1):S13\u2010S27."},{"key":"e_1_2_8_1_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2009.02780.x"},{"key":"e_1_2_8_1_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2008.09.034"},{"key":"e_1_2_8_1_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2003.00985.x"},{"key":"e_1_2_8_1_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-9990"},{"key":"e_1_2_8_1_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa042973"},{"key":"e_1_2_8_1_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199511093331901"},{"key":"e_1_2_8_1_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2011.03361.x"},{"key":"e_1_2_8_1_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02763.x"},{"key":"e_1_2_8_1_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2015.05.017"},{"key":"e_1_2_8_1_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e31815a55f3"},{"key":"e_1_2_8_1_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(89)90536-X"},{"key":"e_1_2_8_1_14_1","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.2011.521740"},{"issue":"3","key":"e_1_2_8_1_15_1","first-page":"327","article-title":"Comparison of newborn outcomes in women with gestational diabetes mellitus treated with metformin or insulin: A randomised blinded trial","volume":"4","author":"Mesdaghinia E.","year":"2013","journal-title":"International Journal of Preventive Medicine"},{"key":"e_1_2_8_1_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-1848"},{"issue":"11","key":"e_1_2_8_1_17_1","first-page":"1011","article-title":"Metformin and insulin in the management of gestational diabetes mellitus: Preliminary results of a comparison","volume":"52","author":"Moore L. 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