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Medical Forum / Diseases and Disorders / Diabetes / March 2006Metformin and Pregnancy
The wife's OB is recommending continuing her metformin during pregnancy. The conventional wisdom is that you're supposed to stop, but is that due to real, documented problems, or just an apparent lack of data showing no problems because too many people just parrot the standard line without keeping-up on current research?  SignatureA: No. See: Help, I'm <http://www.netmeister.org/news/learn2quote.html> being held <http://www.greenend.org.uk/rjk/2000/06/14/quoting> in a .sig Q: Should I include quotations after my reply? factory! > The wife's OB is recommending continuing her metformin during > pregnancy. The conventional wisdom is that you're supposed to stop, > but is that due to real, documented problems, or just an apparent lack > of data showing no problems because too many people just parrot the > standard line without keeping-up on current research? You really need to take this one up with your wife's ob. There was a time when insulin was the preferred method for pregnant type 2's, now I am seeing more and more women saying they are still on their Metformin. Perhaps current research has led to a change. > You really need to take this one up with your wife's ob. > There was a time when insulin was the preferred method for > pregnant type 2's, now I am seeing more and more women > saying they are still on their Metformin. Perhaps current > research has led to a change. It has, but I believe it's the reproductive endocrinology research, not diabetes research. I recall that women with PCOS were being told to stay on metformin during pregnancy, successfully. Susan > > You really need to take this one up with your wife's ob. There > > was a time when insulin was the preferred method for pregnant [quoted text clipped - 5 lines] > not diabetes research. I recall that women with PCOS were being > told to stay on metformin during pregnancy, successfully. I'm finding just the opposite. It's interesting is that essentially none of the PCOS research appears in OB-related journals, everything I've encountered (as a side effect of the metformin/pregnancy research I'm doing) has been in diabetes related journals. SignatureA: No. See: Help, I'm <http://www.netmeister.org/news/learn2quote.html> being held <http://www.greenend.org.uk/rjk/2000/06/14/quoting> in a .sig Q: Should I include quotations after my reply? factory! > I'm finding just the opposite. It's interesting is that essentially > none of the PCOS research appears in OB-related journals, everything > I've encountered (as a side effect of the metformin/pregnancy > research I'm doing) has been in diabetes related journals. When I developed PCOS, I noted the same thing about none of it being in OB/GYN journals. Several years ago, repro endos were just beginning to use metformin for PCOS and it was still controversial. There was info on PCOS in diabetes and endo journals, but that's not where the treatment protocols were coming from. Susan > The wife's OB is recommending continuing her metformin during > pregnancy. The conventional wisdom is that you're supposed to stop, > but is that due to real, documented problems, or just an apparent lack > of data showing no problems because too many people just parrot the > standard line without keeping-up on current research? AFAIK, lack of data. SignatureSee my webpage: http://mysite.verizon.net/juliebove/index.htm >The wife's OB is recommending continuing her metformin during >pregnancy. The conventional wisdom is that you're supposed to stop, >but is that due to real, documented problems, or just an apparent lack >of data showing no problems because too many people just parrot the >standard line without keeping-up on current research? I am pregnant now and was pregnant in 2004. I am a type 2 and was on metformin before pregnancy. Both times they had me stop metformin as soon as I found out I was pregnant. I suggest you join the forum at http://www.diabeticmommy.com/ , many pregnant diabetics post there. You will find the answer what other pregnant diabetics are doing. Andrea2 Type 2 >>The wife's OB is recommending continuing her metformin during >>pregnancy. The conventional wisdom is that you're supposed to stop, [quoted text clipped - 8 lines] > metformin before pregnancy. Both times they had me stop metformin as > soon as I found out I was pregnant. Why is the treatment so different for type 2 than it is for PCOS? Those women stay on metformin during pregnancy, IIRC, because of the high rate of miscarriage in PCOS. Susan > x-no-archive: yes > [quoted text clipped - 16 lines] > > Susan\ My ex-husbands wife has PCOS and was also on Metformin during her pregnancy. She had a baby this past November (a preemie, born at 33 weeks) SignatureSuzi A1c 6.4 T2 DX 10/2002 Glucophage 2 x 1000mg Lipitor 20mg (3 days a week), Enalapril 20mg 30 minutes walks 7 days a week >x-no-archive: yes > [quoted text clipped - 16 lines] > >Susan Not sure about PCOS. However, for Andrea, they are treating Andrea's T2 in a situation that has been found to be, in the past, precarious. Andrea, from what I gather is not enjoying an easy pregnancy, so her treatment may well be exclusive to her needs as opposed to what might happen to other T2's who enjoy easier pregnancies. Keep it to Usenet please wrote in message ... >The wife's OB is recommending continuing her metformin during >pregnancy. The conventional wisdom is that you're supposed to stop, >but is that due to real, documented problems, or just an apparent lack >of data showing no problems because too many people just parrot the >standard line without keeping-up on current research? No parroting, just fear on the part of doctors. Medical school and malpractice lawyers pound conservatism into doctors' heads. I have read accounts of doctors using metformin for pregnancy. I have never read about a problem. However, pregnancy doubles a woman's insulin needs. If your wife was clearly diabetic (i.e. clearly insulin deficient) before pregnancy, she has a really good chance of ending up on insulin anyway. If she were my daughter-in-law, I would have the insulin in her refrigerator right now. One of my G.D. friends had a very, very good ob-gyn who had the rule: two sugars above 120 for any reason and the patient goes on insulin. She ended up on insulin. It's now 12 years later and her doc says T2 is coming but it clearly isn't here yet. Regards Old Al >Keep it to Usenet please wrote in message ... >>The wife's OB is recommending continuing her metformin during [quoted text clipped - 5 lines] > No parroting, just fear on the part of doctors. Medical school and >malpractice lawyers pound conservatism into doctors' heads. Hello Al, Just as an aside, don't blame lawyers.... Blame bad toilet training when the doctors were toddlers. Some of them have a tendency to want to hold on to things that are better dumped and let go! Will, T2 > No parroting, just fear on the part of doctors. Medical school > and malpractice lawyers pound conservatism into doctors' heads. I guess you've had better experiences with MD's than we have. We've run into too many that don't keep up-to date and still think their decisions are beyond question. One doctor even gave us the condescending, "Oh, you have to be careful about what you read on the internet." line after we started asking questions about recent research and then hemmed & hawed and gave us an intelligence insulting cop-out when we pulled-out a stack of Medline abstracts and it was painfully obvious he wasn't up-to-date. What makes that even worse is that he was a high-rick pregnancy expert > However, pregnancy doubles a woman's insulin needs ... I would have > the insulin in her refrigerator right now. Oh we do. She's insulin dependant T1.5 (technically Type-2, but early onset and not really related to diet/weight). The OB is looking a restarting the Metformin because her BG tends to swing (even if she eats the same things at the same times several days in a row, her BG will be up and down without much correlation to diet or activity) since she's been off it. SignatureA: No. See: Help, I'm <http://www.netmeister.org/news/learn2quote.html> being held <http://www.greenend.org.uk/rjk/2000/06/14/quoting> in a .sig Q: Should I include quotations after my reply? factory! Keep it to Usenet please wrote in message ... >. . .(snip). . . > [quoted text clipped - 7 lines] >row, her BG will be up and down without much correlation to diet or >activity) since she's been off it. There is an opinion out there that a large number of apparent Type 1.5 are really adult-onset Type 1. (Been there, done that) Although somewhere between 10% and 20% (a very uncertain statistic) of T2 do not exhibit obesity or signs of high Insulin Resistance, non-obese, well-exercised adult-onset diabetics should be very much aware that they could merely be in the longish honeymoon often seen in adult-onset T1. FWIW, althought diabetes statistics are really lousy (they don't even know how many are out there), there is reason to believe that adult-onset T1 outnumber juvenile-onset T1 by over 2:1. Regards Old Al |
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