Metformin in pregnancy to avert gestational diabetes in women at high risk: Meta‐analysis of randomized controlled trials
Open accessAbstract
Summary: Previous randomized and observational studies on the efficacy of metformin in pregnancy to reduce incident gestational diabetes mellitus (GDM) in women at high risk (obesity, polycystic ovary syndrome [PCOS], or pregestational insulin resistance) have been conflicting and several groups are planning further randomized controlled trials (RCTs) to answer this question conclusively. This work assesses the efficacy of metformin in pregnancy to avert one outcome—incident GDM in women at high risk. We included RCTs comparing metformin with usual care or placebo controls in terms of incident GDM and recruiting women at high risk during early pregnancy. Eleven eligible trials enrolled 2370 adult women whose intervention arm consisted of metformin started at conception or before 20 weeks of gestation. Risk of GDM was similar in intervention compared with controls (risk ratio [RR] 1.03; 95% confidence interval [CI], 0.85‐1.24). The data were of sufficient quality meeting the criteria for consistency and directness. We conclude that metformin does not contribute to averting the GDM outcome in women at high risk when initiated in pregnancy. The evidence provided by this synthesis affirms that further broad clinical trials investigating this question are no longer needed.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Metformin treatment in pregnancy does not reduce the risk of GDM in high-risk individuals with obesity, polycystic ovary syndrome, or preexisting insulin resistance.
“A meta-analysis of 11 RCTs demonstrated that metformin treatment in pregnancy does not reduce the risk of GDM in highrisk individuals with obesity, polycystic ovary syndrome, or preexisting insulin resistance (61).”
From 15. Management of Diabetes in Pregnancy: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [61]
Cites
1 retracted
Khattab, S., Mohsen, I. A., Foutouh, I. A., ashmawi, H. S., Mohsen, M., van Wely, M., van der Veen, F., & Youssef, M. A. F. M. (2011) · Gynecological Endocrinology · doi:10.3109/09513590.2010.540600 · Cited by 69 · see citing works
RetractedMeasuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139 · see citing works
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552 · see citing works
Quantifying heterogeneity in a meta‐analysis
Higgins, J. P. T., & Thompson, S. G. (2002) · Statistics in Medicine · doi:10.1002/sim.1186 · Cited by 36,763 · see citing works
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164 · see citing works
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305 · cited 1× · see citing works
“Strengths of this synthesis include explicit eligibility criteria; a comprehensive search developed with a research librarian; a comprehensive risk of bias assessment culminating in bias adjustment, consideration of a specific outcome important to patients; consideration of selective reporting bias; consideration of p…”
MethodLiberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · BMJ · doi:10.1136/bmj.b2700 · Cited by 17,648 · see citing works
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00136 · Cited by 10,349 · see citing works
Sterne, J. A. C., Sutton, A. J., Ioannidis, J. P. A., Terrin, N., Jones, D. R., Lau, J., Carpenter, J., Rucker, G., Harbord, R. M., Schmid, C. H., et al. (2011) · BMJ · doi:10.1136/bmj.d4002 · Cited by 7,709 · see citing works
International Association of Diabetes and Pregnancy Study Groups Consensus Panel (2010) · Diabetes Care · doi:10.2337/dc09-1848 · Cited by 5,390 · see citing works
Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance.
National Diabetes Data Group (1979) · Diabetes · doi:10.2337/diab.28.12.1039 · Cited by 4,909 · see citing works
Diagnosis and Classification of diabetes mellitus
Rossi, G. (2014) · Diapedia.org eBooks · doi:10.14496/dia..20 · Cited by 3,212 · see citing works
Interaction revisited: the difference between two estimates.
Altman, D. G., & Bland, J. M. (2003) · BMJ · doi:10.1136/bmj.326.7382.219 · Cited by 3,203 · see citing works
Metzger, B. E., Gabbe, S. G., Persson, B., Lowe, L. P., Dyer, A. R., Oats, J. J. N., & Buchanan, T. A. (2010) · Diabetes Care · doi:10.2337/dc10-0719 · Cited by 1,888 · see citing works
The Pathophysiology of Gestational Diabetes Mellitus
Plows, J. F., Stanley, J. L., Baker, P. N., Reynolds, C. M., & Vickers, M. H. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19113342 · Cited by 1,874 · cited 4× · see citing works
“In most cases, this hyperglycaemia is the result of impaired glucose tolerance due to pancreatic beta‐cell dysfunction on a background of chronic insulin resistance.(1) Consequences of GDM include increased risk of maternal cardiovascular disease and type 2 diabetes and macrosomia and birth complications in the infant.”
BackgroundInfluentialBuchanan, T. A., Xiang, A. H., Peters, R. K., Kjos, S. L., Marroquin, A., Goico, J., Ochoa, C., Tan, S., Berkowitz, K., Hodis, H. N., et al. (2002) · Diabetes · doi:10.2337/diabetes.51.9.2796 · Cited by 1,339 · see citing works
(1964) · PubMed · Cited by 1,230 · see citing works
A new improved graphical and quantitative method for detecting bias in meta-analysis
Furuya-Kanamori, L., Barendregt, J. J., & Doi, S. A. R. (2018) · International Journal of Evidence-Based Healthcare · doi:10.1097/xeb.0000000000000141 · Cited by 1,160 · see citing works
Self-citationDiagnosis and Classification of Diabetes Mellitus
American Diabetes Association (2008) · Diabetes Care · doi:10.2337/dc08-s055 · Cited by 1,062 · see citing works
A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome
Boomsma, C. M., Eijkemans, M. J. C., Hughes, E. G., Visser, G. H. A., Fauser, B. C. J. M., & Macklon, N. S. (2006) · Human Reproduction Update · doi:10.1093/humupd/dml036 · Cited by 852 · see citing works
Gestational Diabetes Mellitus: Risks and Management during and after Pregnancy
Buchanan, T. A., Xiang, A. H., & Page, K. A. (2012) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2012.96 · Cited by 718 · see citing works
Santos, S., Voerman, E., Amiano, P., Barros, H., Beilin, L., Bergström, A., Charles, M., Chatzi, L., Chevrier, C., Chrousos, G., et al. (2019) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.15661 · Cited by 591 · see citing works
Doi, S. A. R., Barendregt, J. J., Khan, S., Thalib, L., & Williams, G. M. (2015) · Contemporary Clinical Trials · doi:10.1016/j.cct.2015.05.009 · Cited by 585 · see citing works
Self-citation(2013) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000433006.09219.f1 · Cited by 583 · see citing works
Hoffman, L., Nolan, C. J., Wilson, J. D., Oats, J. J. N., & Simmons, D. S. (1998) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1998.tb140192.x · Cited by 570 · see citing works
Lee, K. W., Ching, S. M., Ramachandran, V., Yee, A., Hoo, F. K., Chia, Y. C., Wan Sulaiman, W. A., Suppiah, S., Mohamed, M. H., & Veettil, S. K. (2018) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-018-2131-4 · Cited by 546 · see citing works
Terrin, N. C., Schmid, C. H., & Lau, J. (2005) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2005.01.006 · Cited by 493 · see citing works
Hyperglycemia and Adverse Pregnancy Outcomes
Metzger, B. E., Lowe, L. P., Dyer, A. R., Trimble, E. R., Chaovarindr, U., Coustan, D. R., Hadden, D. R., McCance, D. R., Hod, M., McIntyre, H. D., et al. (2009) · Obstetric Anesthesia Digest · doi:10.1097/01.aoa.0000344706.95925.dc · Cited by 479 · see citing works
Metformin versus placebo in obese pregnant women without diabetes mellitus
Syngelaki, A., Nicolaides, K. H., Balani, J., Hyer, S., Akolekar, R., Kotecha, R., Pastides, A., & Shehata, H. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1509819 · Cited by 394 · see citing works
Behboudi-Gandevani, S., Amiri, M., Bidhendi Yarandi, R., & Ramezani Tehrani, F. (2019) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-019-0406-1 · Cited by 321 · see citing works
Dixon, J. B., & O’Brien, P. E. (2002) · Diabetes Care · doi:10.2337/diacare.25.2.358 · Cited by 319 · see citing works
Vanky, E., Stridsklev, S., Heimstad, R., Romundstad, P., Skogøy, K., Kleggetveit, O., Hjelle, S., von Brandis, P., Eikeland, T., Flo, K., et al. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-0853 · Cited by 315 · see citing works
Chiswick, C., Reynolds, R. M., Denison, F., Drake, A. J., Forbes, S., Newby, D. E., Walker, B. R., Quenby, S., Wray, S., Weeks, A., et al. (2015) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(15)00219-3 · Cited by 260 · see citing works
Gastric bypass and banding equally improve insulin sensitivity and β cell function
Bradley, D., Conte, C., Mittendorfer, B., Eagon, J. C., Varela, J. E., Fabbrini, E., Gastaldelli, A., Chambers, K. T., Su, X., Okunade, A., et al. (2012) · Journal of Clinical Investigation · doi:10.1172/jci64895 · Cited by 244 · see citing works
Vanky, E., Salvesen, K., Heimstad, R., Fougner, K., Romundstad, P., & Carlsen, S. (2004) · Human Reproduction · doi:10.1093/humrep/deh347 · Cited by 242 · see citing works
Advances in the meta-analysis of heterogeneous clinical trials II: The quality effects model
Doi, S. A. R., Barendregt, J. J., Khan, S., Thalib, L., & Williams, G. M. (2015) · Contemporary Clinical Trials · doi:10.1016/j.cct.2015.05.010 · Cited by 227 · see citing works
Self-citationCallaway, L. K., McIntyre, H. D., Barrett, H. L., Foxcroft, K., Tremellen, A., Lingwood, B. E., Tobin, J. M., Wilkinson, S., Kothari, A., Morrison, M., et al. (2019) · Diabetes Care · doi:10.2337/dc18-2248 · Cited by 187 · see citing works
Løvvik, T. S., Carlsen, S. M., Salvesen, Ø., Steffensen, B., Bixo, M., Gómez-Real, F., Lønnebotn, M., Hestvold, K. V., Zabielska, R., Hirschberg, A. L., et al. (2019) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(19)30002-6 · Cited by 176 · see citing works
Core outcome sets in women's and newborn health: a systematic review
Duffy, J. M., Rolph, R. C., Gale, C., Hirsch, M., Khan, K. S., Ziébland, S., & McManus, R. J. (2017) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.14694 · Cited by 166 · see citing works
Hyperglycemia and Adverse Pregnancy Outcomes
Metzger, B. E., Coustan, D. R., & Trimble, E. R. (2019) · Clinical Chemistry · doi:10.1373/clinchem.2019.303990 · Cited by 122 · see citing works
Meta-analysis in evidence-based healthcare
Doi, S. A. R., Furuya‐Kanamori, L., Thalib, L., & Barendregt, J. J. (2017) · International Journal of Evidence-Based Healthcare · doi:10.1097/xeb.0000000000000125 · Cited by 100 · see citing works
Self-citationDodd, J., Louise, J., Deussen, A., Grivell, R., Dekker, G., McPhee, A., & Hague, W. (2019) · The Lancet Diabetes and Endocrinology · doi:10.1016/s2213-8587(18)30310-3 · Cited by 96 · see citing works
Prevention of gestational diabetes by metformin plus diet in patients with polycystic ovary syndrome
Glueck, C. J., Pranikoff, J., Aregawi, D., & Wang, P. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.03.036 · Cited by 81 · see citing works
Metformin in Pregnancy: Mechanisms and Clinical Applications
Hyer, S. L., Balani, J., & Shehata, H. A. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19071954 · Cited by 80 · see citing works
Effects of metformin on pregnancy outcomes in women with polycystic ovary syndrome
Zeng, X., Zhang, Y., Tian, Q., Xue, Y., & An, R. (2016) · Medicine · doi:10.1097/md.0000000000004526 · Cited by 78 · see citing works
Endo, S., Maeda, K., Suto, M., Kaji, T., Morine, M., Kinoshita, T., Yasui, T., & Irahara, M. (2006) · Gynecological Endocrinology · doi:10.1080/09513590600724836 · Cited by 75 · see citing works
Khomami, M. B., Joham, A. E., Boyle, J. A., Piltonen, T., Arora, C., Silagy, M., Misso, M. L., Teede, H. J., & Moran, L. (2019) · Obesity Reviews · doi:10.1111/obr.12832 · Cited by 75 · see citing works
Begum, M. R., Khanam, N. N., Quadir, E., Ferdous, J., Begum, M. S., Khan, F. I., & Begum, A. (2008) · Journal of obstetrics and gynaecology research · doi:10.1111/j.1447-0756.2008.00876.x · Cited by 70 · see citing works
Dodd, J. M., Grivell, R. M., Deussen, A. R., & Hague, W. M. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010564.pub2 · Cited by 69 · see citing works
Tackling poorly selected, collected, and reported outcomes in obstetrics and gynecology research
Duffy, J. M., Ziébland, S., von Dadelszen, P., & McManus, R. J. (2018) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2018.09.023 · Cited by 56 · see citing works
Bashir, M., Baagar, K. A. M., Naem, E., Elkhatib, F., Alshaybani, N., Konje, J. C., & Abou‐Samra, A. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-023612 · Cited by 56 · see citing works
Zhuo, Z., Wang, A., & Yu, H. (2014) · Journal of Diabetes Research · doi:10.1155/2014/381231 · Cited by 55 · see citing works
Tan, X., Li, S., Chang, Y., Fang, C., Liu, H., Zhang, X., & Wang, Y. (2016) · Clinical and Investigative Medicine · doi:10.25011/cim.v39i4.27091 · Cited by 51 · see citing works
Feng, L., Lin, X.-F., Wan, Z.-H., Hu, D., & Du, Y.-K. (2015) · Gynecological Endocrinology · doi:10.3109/09513590.2015.1041906 · Cited by 50 · see citing works
Fougner, K. J., Vanky, E., & Carlsen, S. M. (2008) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.1080/00365510802254620 · Cited by 43 · see citing works
Nawaz, F. H., & Rizvi, J. (2009) · Gynecologic and Obstetric Investigation · doi:10.1159/000268051 · Cited by 43 · see citing works
A unified framework for bias assessment in clinical research
Stone, J., Glass, K., Clark, J. M., Munn, Z., Tugwell, P., & Doi, S. A. R. (2019) · International Journal of Evidence-Based Healthcare · doi:10.1097/xeb.0000000000000165 · Cited by 42 · see citing works
Self-citationWaffenschmidt, S., Janzen, T., Hausner, E., & Kaiser, T. (2013) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2012.11.011 · Cited by 40 · see citing works
Jamal, A. S., Milani, F., & Alyasin, A. (2012) · PubMed Central · Cited by 39 · see citing works
Xiang, A. H., Trigo, E., Martinez, M., Katkhouda, N., Beale, E., Wang, X., Wu, J., Chow, T., Montgomery, C., Nayak, K. S., et al. (2018) · Diabetes Care · doi:10.2337/dc18-1662 · Cited by 37 · see citing works
Heterogeneity of gestational diabetes (GDM) and challenges in developing a GDM risk score
Huvinen, E., Eriksson, J. G., Stach‐Lempinen, B., Tiitinen, A. E., & Koivusalo, S. B. (2018) · Acta Diabetologica · doi:10.1007/s00592-018-1224-x · Cited by 36 · see citing works
Nguyen, C. L., Lee, A. H., Pham, N. M., Nguyen, P. T. H., Ha, A. V. V., Chu, T. K., Duong, D., Duong, H. T., & Binns, C. W. (2019) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2019.1583733 · Cited by 35 · see citing works
Madhuvrata, P., Govinden, G., Bustani, R., Song, S. H., & Farrell, T. J. (2015) · Obstetric Medicine · doi:10.1177/1753495x15576673 · Cited by 33 · see citing works
Kampmann, F. B., Thuesen, A. C. B., Hjort, L., Olsen, S. F., Pires, S. M., Tetens, I., & Grunnet, L. G. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-02044 · Cited by 33 · see citing works
Dodd, J. M., Grivell, R. M., Deussen, A. R., & Hague, W. M. (2019) · Yearbook of pediatric endocrinology · doi:10.1530/ey.16.2.11 · Cited by 33 · see citing works
Zheng, J., Shan, P. F., & Gu, W. (2013) · PubMed · doi:10.3275/8932 · Cited by 31 · see citing works
Zhao, J., Liu, X., & Zhang, W. (2020) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/a-0603-3394 · Cited by 31 · see citing works
Elmaraezy, A., Abushouk, A. I., Emara, A., Elshahat, O., Ahmed, H., & Mostafa, M. I. (2017) · International Journal of Reproductive BioMedicine (IJRM) · doi:10.29252/ijrm.15.8.461 · Cited by 30 · see citing works
Valdés, E., Sepúlveda-Martínez, Á., Paula Candia, P., Abusada, N., Orellana, R., Manukian, B., & Cuellar, E. (2017) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.13477 · Cited by 30 · see citing works
Bidhendi Yarandi, R., Behboudi-Gandevani, S., Amiri, M., & Ramezani Tehrani, F. (2019) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-019-0453-7 · Cited by 29 · see citing works
Sales, W., Nascimento, I. B., Dienstmann, G., de Souza, M. L. R., da Silva, G. D., & Silva, J. (2018) · Gynecologie et obstetrique · doi:10.1055/s-0038-1642632 · Cited by 24 · see citing works
Hameed, A. A. A. E., Shreif, H. E., & Mowafy, H. E. M. (2011) · Middle East Fertility Society Journal · doi:10.1016/j.mefs.2011.04.002 · Cited by 20 · see citing works
Metformin for preventing gestational diabetes in women with polycystic ovarian syndrome.
Ainuddin, J. A., Kazi, S., Aftab, S., & Kamran, A. (2015) · PubMed · Cited by 18 · see citing works
How Metformin Acts in PCOS Pregnant Women
Romualdi, D., Cicco, S. D., Gagliano, D., Busacca, M., Campagna, G., Lanzone, A., & Guido, M. (2013) · Diabetes Care · doi:10.2337/dc12-2071 · Cited by 16 · see citing works
Metformin in women at high risk of gestational diabetes mellitus
Brink, H. S., Alkemade, M., van der Lely, A. J., & van der Linden, J. (2018) · Diabetes & Metabolism · doi:10.1016/j.diabet.2018.01.008 · Cited by 10 · see citing works
ADMETAN: Stata module to provide comprehensive meta-analysis
Fisher, D. J. (2018) · RePEc: Research Papers in Economics · Cited by 10 · see citing works
Metformin and Pregnancy Outcomes: Evidence Gaps and Unanswered Questions
González, C. D., Alvariñas, J., Bagnes, M. F. G., & Girolamo, G. D. (2018) · Current Clinical Pharmacology · doi:10.2174/1574884714666181224151116 · Cited by 9 · see citing works
Musa, O. A. H., Islam, N., Thalib, L., & Doi, S. A. R. (2019) · Obesity Reviews · doi:10.1111/obr.12913 · Cited by 4 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
15. Management of Diabetes in Pregnancy: <i>Standards of Medical Care in Diabetes—2022</i>
American Diabetes Association Professional Practice Committee (2022) · Diabetes Care · doi:10.2337/dc22-s015 · Cited by 504 · see citing works
Endometrial function in women with polycystic ovary syndrome: a comprehensive review
Palomba, S., Piltonen, T., & Giudice, L. C. (2020) · Human Reproduction Update · doi:10.1093/humupd/dmaa051 · Cited by 385 · see citing works
15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2023
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D. M., Johnson, E. L., et al. (2022) · Diabetes Care · doi:10.2337/dc23-s015 · Cited by 309 · see citing works
15. Management of Diabetes in Pregnancy: <i>Standards of Care in Diabetes—2024</i>
American Diabetes Association Professional Practice Committee, ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Hilliard, M. E., Johnson, E. L., Khunti, K., et al. (2024) · Diabetes Care · doi:10.2337/dc24-s015 · Cited by 232 · see citing works
15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Ekhlaspour, L., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s015 · Cited by 252 · see citing works
The Current and Potential Therapeutic Use of Metformin—The Good Old Drug
Drzewoski, J., & Hanefeld, M. (2021) · Pharmaceuticals · doi:10.3390/ph14020122 · Cited by 165 · see citing works
15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2026
Bajaj, M. S., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Early, K. B., Brown, F. M., ChallaSivaKanaka, S., et al. (2025) · Diabetes Care · doi:10.2337/dc26-s015 · Cited by 114 · see citing works
Stone, J., Glass, K., Clark, J. M., Ritskes-Hoitinga, M. J., Munn, Z., Tugwell, P., & Doi, S. A. R. (2021) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2021.01.012 · Cited by 85 · see citing works
Self-citationMitochondrial dysfunction in the fetoplacental unit in gestational diabetes mellitus
Sobrevía, L., Valero, P., Grismaldo, A., Villalobos-Labra, R., Pardo, F., Subiabre, M., Armstrong, G. A., Toledo, F., Vega, S., Cornejo, M., et al. (2020) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2020.165948 · Cited by 74 · see citing works
Wu, Y., Tu, M., Huang, Y., Liu, Y., & Zhang, D. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.11995 · Cited by 71 · see citing works
Metformin for diabetes prevention: update of the evidence base
Gottwald‐Hostalek, U., & Campbell, I. W. (2021) · Current Medical Research and Opinion · doi:10.1080/03007995.2021.1955667 · Cited by 66 · see citing works
Wiedemann, P., Sorgente, N., Bekhor, C., Patterson, R., Tran, T., & Ryan, S. J. (1985) · PubMed · Cited by 53 · see citing works
Efficacy and safety of metformin during pregnancy: an update
Paschou, S. Α., Shalit, A., Gerontiti, E., Athanasiadou, K. I., Kalampokas, T., Ψαλτοπούλου, Θ., Lambrinoudaki, I. V., Anastasiou, E., Wolffenbuttel, B. H. R., & Goulis, D. G. (2023) · Endocrine · doi:10.1007/s12020-023-03550-0 · Cited by 48 · see citing works
Physical activity in pregnancy prevents gestational diabetes: A meta-analysis
Doi, S. A. R., Furuya-Kanamori, L., Toft, E., Musa, O. A. H., Mohamed, A. M., Clark, J., & Thalib, L. (2020) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2020.108371 · Cited by 33 · see citing works
Self-citationXu, C., Furuya‐Kanamori, L., Kwong, J. S. W., Li, S., Liu, Y., & Doi, S. A. R. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101434 · Cited by 30 · see citing works
Self-citationAlbaghdadi, A. J. H., & Kan, F. W. K. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22062872 · Cited by 26 · see citing works
Fougner, S. L., Vanky, E., Løvvik, T. S., & Carlsen, S. M. (2021) · PLOS ONE · doi:10.1371/journal.pone.0254895 · Cited by 23 · see citing works
“However, this lack of effect of metformin on glucose metabolism in pregnant women has also been observed in previous RCTs on cohorts of overweight and obese pregnant women [40–43] and in a recent meta-analysis of RCTs on cohorts of women with increased GDM risk [44].”
ResultEffects of metformin treatment on pregnancy outcomes in patients with polycystic ovary syndrome
Raperport, C., Chronopoulou, E., & Homburg, R. (2021) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2021.1889366 · Cited by 21 · see citing works
Polycystic ovary syndrome and pregnancy – From a clinical perspective
Vanky, E., & Løvvik, T. S. (2020) · Current Opinion in Endocrine and Metabolic Research · doi:10.1016/j.coemr.2020.01.005 · Cited by 21 · see citing works
Musa, O. A. H., Syed, A., Mohamed, A. M., Chivese, T., Clark, J. M., Furuya‐Kanamori, L., Xu, C., Toft, E. S., Bashir, M., Abou‐Samra, A., et al. (2021) · Pharmacological Research · doi:10.1016/j.phrs.2021.105546 · Cited by 19 · see citing works
Self-citationBashir, M., Syed, A., Furuya‐Kanamori, L., Musa, O. A. H., Mohamed, A. M., Skarulis, M. C., Thalib, L., Konje, J. C., Abou‐Samra, A., & Doi, S. A. R. (2020) · Obesity Science & Practice · doi:10.1002/osp4.480 · Cited by 15 · see citing works
Self-citationManagement of Women with Polycystic Ovary Syndrome During Pregnancy
Valent, A. M., & Barbour, L. A. (2021) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2020.10.005 · Cited by 17 · see citing works
Metformin in gestational diabetes: physiological actions and clinical applications
Mason, T., Alesi, S., Fernando, M., Vanky, E., Teede, H. J., & Mousa, A. (2024) · Nature Reviews Endocrinology · doi:10.1038/s41574-024-01049-w · Cited by 16 · see citing works
A narrative review of metformin in pregnancy: Navigating benefit and uncertainty
McEvoy, R. P., Newman, C., Egan, A. M., & Dunne, F. (2025) · Diabetes Obesity and Metabolism · doi:10.1111/dom.16361 · Cited by 13 · see citing works
Screening and management of major endocrinopathies during pregnancy: an update
Paschou, S. Α., Bletsa, E., Papazisi, M., Mili, N., Kanouta, F., Kassi, G., Ψαλτοπούλου, Θ., Goulis, D. G., & Lambrinoudaki, I. V. (2022) · Endocrine · doi:10.1007/s12020-022-03237-y · Cited by 13 · see citing works
Yu, H., Sun, J., & Hu, H. (2023) · Irish Journal of Medical Science (1971 -) · doi:10.1007/s11845-023-03380-z · Cited by 12 · see citing works
Comment on a review of methods to assess publication and other reporting biases in meta‐analysis
Furuya‐Kanamori, L., Lin, L., & Doi, S. A. R. (2022) · Research Synthesis Methods · doi:10.1002/jrsm.1550 · Cited by 6 · see citing works
Self-citationZeng, W., Luo, Y., Ou, J., Gan, D., Huang, M., Tomlinson, B., & Jiang, Y. (2025) · Frontiers in Pharmacology · doi:10.3389/fphar.2025.1654372 · Cited by 5 · see citing works
Versace, V. L., Beks, H., Hannah, W., Namara, K. M., Hague, W. M., Anjana, R. M., Mohan, V., Khunti, K., & Dunbar, J. (2020) · Seminars in Reproductive Medicine · doi:10.1055/s-0041-1727203 · Cited by 5 · see citing works
Obesity in patients with gestational diabetes: Impact on newborn outcomes
Bertoli, J. P. D. P., Schulz, M. A., Silva, R. R. E., da Silva, J. O. N., de Souza, M. L. R., & Silva, J. C. (2020) · Obesity Medicine · doi:10.1016/j.obmed.2020.100296 · Cited by 3 · see citing works
Chen, X., Du, Z., Zhang, Z., & Chen, D. (2024) · Food Science & Nutrition · doi:10.1002/fsn3.4601 · Cited by 2 · see citing works
Metformin in High Metabolic Risk Pregnancies — A Patient-Level Meta-Analysis
Mousa, A., Løvvik, T. S., Carlsen, S., Belsti, Y., Enticott, J., Tay, C. T., Nikkinen, H., Morin-Papunen, L. C., Tertti, K., Rönnemaa, T., et al. (2026) · NEJM Evidence · doi:10.1056/evidoa2500337 · Cited by 2 · see citing works
Metformin therapy in pregnancy [Zastosowanie metforminy w ciąży]
Krupej, J., Cichocka, E., Kędzierski, L., Okopień, B., & Gumprecht, J. (2020) · Endokrynologia Polska · doi:10.5603/ep.a2020.0016 · Cited by 2 · see citing works
Bomba-Opon, D. A., Gutaj, P., Kędzia, M., Leszczyńska‐Gorzelak, B., Majewska, A., Radzicka, S., Stanirowski, P. J., & Wender-Ożegowska, E. (2023) · Ginekologia Polska · doi:10.5603/gpl.97361 · Cited by 1 · see citing works
Hipoglucemiantes orales en el control metabólico de la diabetes gestacional.
Lazo-Feijoo, L. A., & Campoverde, L. H. M. (2023) · MQRInvestigar · doi:10.56048/mqr20225.7.3.2023.2454-2482 · Cited by 1 · see citing works
Agents anti-hyperglycémiants oraux et grossesse
Cosson, E., Pinto, S., Rezgani, I., Barka, I., Sal, M., Zerguine, M., Tatulashvili, S., & Bihan, H. (2024) · Médecine des Maladies Métaboliques · doi:10.1016/j.mmm.2024.01.003
Features of Hypoglycemic Pharmacotherapy of Gestational Diabetes Mellitus
Чак, Т. А., Высоцкая, Ю. В., Романова, И. С., & Кожанова, И. Н. (2023) · Рецепт · doi:10.34883/pi.2023.26.6.011
Amiri, M., Kamrani, M. A., Qaderi, K., & Amoli, M. M. (2026) · Reproductive Sciences · doi:10.1007/s43032-026-02226-0
Fuglsang, J., Kampmann, U., Johnsen, S. K., McIntyre, D. H., & Ovesen, P. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-13265-0.00007-0
- Authors
- Doi, S. A. R., Furuya‐Kanamori, L., Toft, E., Musa, O. A. H., Islam, N., Clark, J., & Thalib, L.
- Affiliations
- Qatar University (QA)
- Australian National University (AU)
- Bond University (AU)
- Corresponding author
- Doi, Suhail A.R.
- ORCID
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2019-10-31
- Volume
- 21
- Issue
- 1
- Pages
- e12964-e12964
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W2985343341
- Cited by
- 39
- References
- 78
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 3 · 2021: 10 · 2020: 9
- FWCI
- 0.87
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- Yildiz Technical University - AVESIS (submittedVersion)
- Bond University Research Portal (Bond University) (submittedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- Qatar University QSpace (Qatar University) (submittedVersion)
- Griffith Research Online (submittedVersion, other-oa)
- Funders
- Qatar National Research Fund (NPRP10‐0129‐170274)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- metformin, gestational diabetes mellitus, pregnancy, high-risk women, polycystic ovary syndrome, maternal obesity, drug efficacy
- MeSH terms
- Adult, Female, Humans, Hypoglycemic Agents, Metformin, Pregnancy, Randomized Controlled Trials as Topic, Diabetes, Gestational
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
