Metformin, an oral anti-diabetic medication, is the first drug of choice for treating Type 2 diabetes, but its safety in Gestational diabetes (diabetes of pregnancy), has been controversial.
New evidence has been favorable, as a study from the Portuguese Institute of Oncology and Santa Maria Hospital in Lisbon illustrates.
The study, reported in the medical journal Endocrinology Practice in May 2014, included 188 pregnant women diagnosed with Gestational diabetes...

• 32 of the women were treated with metformin,
• 121 of the pregnant women controlled their condition with diet alone, and the remaining
• 33 women were treated with insulin.
  

It was found ten of the metformin treated women had to be treated with insulin along with the oral anti-diabetic drug.
No miscarriages or infant deaths were reported for the metformin group.
When compared with the other two groups, the babies in this group had an equal percent of several health measures...

• low birth weight,
• high birth weight,
• admission to intensive care units,
• prematurity,
• birth defects, and
• birth injuries.
  

Mothers in the metformin group had an equal percent of illness and cesarean deliveries.
In 2011 Diabetes Care, the journal of the American Diabetes Association, published an article citing several studies on the use of this oral anti-diabetic medication in pregnancy.
The conclusion was the drug is safe for use during pregnancy as far as immediate effects were concerned.
The authors went on to speculate since metformin is known to cross from the mother's blood to the baby, that possible long-range effects should be investigated.
Metformin has been used during pregnancy since the late 1970's in South Africa, so perhaps we can hope to see some studies on long-range effects from there.
Metformin works by slowing down the liver's manufacture of sugar and by making the body more sensitive to insulin.
It also goes by the commercialnames...

• Glucophage,
• Glucophage XR,
• Glumetza,
• Fortamet, and
• Riomet.
  

It is taken by mouth either by tablet or dissolved in liquid.
The medication is usually given at a lower dose of 500 to 1000 mg to begin with to avoid nausea, to be taken with the evening meal.
The dosage is then gradually increased to 2000 to 2500 mg.
Diabetics taking one of these oral anti-diabetic drugs are also given a diet and exercise plan to follow.
Lots of fruits and vegetables with vitamins, minerals, and fiber are important.
Physical activity such as walking is helpful for blood sugar control.
In general most women can tolerate the same activity they performed before pregnancy, but need to be careful about any exercise where balance is essential.
If bleeding or cramps occur, the activity should be stopped and the obstetrician or midwife notified