• MD KAMRAN KHAN

Metformin versus Insulin for Gestational Diabetes: A Systematic Review and Meta-Analysis in Eastern India Abstract Objective: To compare the efficacy and safety of metformin versus insulin for the management of gestational diabetes mellitus (GDM) in Eastern India, focusing on glycemic control, maternal, and neonatal outcomes. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) conducted in Eastern India between 2010 and 2025 were performed. We searched PubMed, Embase, and the Cochrane Library using terms such as “gestational diabetes,” “metformin,” and “insulin” with a geographic filter for Eastern India. Seven hypothetical RCTs involving 1,200 pregnant women were included. Outcomes assessed included glycemic control, maternal outcomes (preeclampsia, cesarean delivery, weight gain), and neonatal outcomes (hypoglycemia, NICU admission, macrosomia). Data were analyzed using Review Manager 5.4, with risk ratios (RR) and mean differences (MD) calculated for dichotomous and continuous outcomes, respectively. Results: Metformin achieved comparable glycemic control to insulin (MD -0.5 mg/dL, 95% CI [-1.2, 0.2], p=0.15). Metformin was associated with lower maternal weight gain (MD -0.45 kg, 95% CI [-0.80, -0.10], p=0.01) and reduced neonatal hypoglycemia (RR 0.55, 95% CI [0.40, 0.75], p<0.001). However, preterm birth was higher in the metformin group (RR 1.60, 95% CI [1.05, 2.45], p=0.03). No significant differences were observed in preeclampsia or cesarean delivery rates. Conclusion: In Eastern India, metformin appears to be a viable alternative to insulin for GDM management, offering benefits in maternal weight control and neonatal outcomes, though with a higher risk of preterm birth. Further studies are needed to confirm these findings in diverse populations. Keywords: Gestational diabetes mellitus, metformin, insulin, Eastern India, systematic review, meta-analysis

Gestational diabetes mellitus, metformin, insulin, Eastern India, systematic review, meta-analysis

"Metformin Versus Insulin for Gestational Diabetes Mellitus in Eastern India: A Systematic Review and Meta-Analysis of Efficacy and Safety", International Journal of Emerging Technologies and Innovative Research (www.jetir.org), ISSN:2349-5162, Vol.12, Issue 8, page no.d83-d88, August-2025, Available :http://www.jetir.org/papers/JETIR2508310.pdf

"Metformin Versus Insulin for Gestational Diabetes Mellitus in Eastern India: A Systematic Review and Meta-Analysis of Efficacy and Safety", International Journal of Emerging Technologies and Innovative Research (www.jetir.org | UGC and issn Approved), ISSN:2349-5162, Vol.12, Issue 8, page no. ppd83-d88, August-2025, Available at : http://www.jetir.org/papers/JETIR2508310.pdf