Background: Overweight and high parity are two of the many risk factors for
gestational diabetes mellitus that affect women in Saudi Arabia. In order to
minimize complications for both the mother and the fetus, care of gestational
diabetes mellitus should involve keeping the patient's plasma glucose levels
within normal ranges and avoiding significant weight gain. Insulin was the first
line of therapy for diabetes during pregnancy. Metformin safety was approved
recently, and it was administered more frequently to pregnant diabetes patients
when insulin cannot be provided. Method: We conducted a thorough search of the
Cochrane database, Embase, and PubMed (from 2015 to 2022). We looked for
randomized controlled trials that contrasted metformin with insulin. Results: In
the systematic review, we considered 6 studies with 996 patients overall. Five
studies excluded mothers with pre-gestational diabetes, and one research did not
state whether pre-gestational diabetes was present. In these six RCTs, 498
participants got insulin therapy, and 498 patients got metformin treatment. In
Ashoush et al., (2016) study, 22% of the metformin group needed insulin
throughout the follow-up period. In most of the included studies the two groups
differed statistically significantly regarding gestational age at birth. Conclusion:
our study shows that, when compared to insulin treatment, metformin can
provide some benefits and acceptable glycemic control without increasing the
risk of certain outcomes for mothers and neonates. More researches were needed
in Middle East and especially in Saudi Arabia.
Keywords: Gestational diabetes mellitus, management, insulin, metformin