Use of metformin for gestational diabetes treatment and its effects in placental nutrient transporters expression.

Objectives: To determine the frequency of use of non-pharmacological and pharmacological treatments in women with GMD and to evaluate the effects of metformin in placental nutrient transporters expression.
Methods: Initially, we conducted a systematic review (SR) based on the recommendations of Cochrane and PRISMA. Furthermore, we performed a comparative study including women who received insulin versus metformin for GDM treatment. Clinical history was recorded and placental tissue was collected after labour. Placental samples were stored for gene expression analysis. Differences in gene expression will be compared by T-student test.
Results: For the SR we included 106 studies. Non-pharmacological treatments were the most common reported 59% (95%, CI 0.55 to 0.64; I2: 99.8%) from 98 studies, followed by insulin treatment 34% (95%, CI 0.29 to 0.39; I2: 99.9%) from 102 studies, metformin treatment 19% (95%, CI 0.17 to 0.22; I2: 99.7%) from 17 studies and glyburide treatment 31% (95%, CI 0.23 to 0.40; I2: 99.9%) from 18 studies. Dual pharmacological treatments were 13% (95%, CI 0.10 to 0.16; I2: 98%) from 11 studies.
For the experimental phase, we are collecting placental samples from women between 18 to 45 years that assisted to more than four prenatal control and had a normal labour process.
Conclusion: Non-pharmacological and insulin treatments were the most used strategies for GDM, however, oral hypoglycemics drugs for GDM treatment has become a common option in the last ten years. Is important to determine the effects of pharmacological GDM treatments in placental function and later on during the adult life.