COGI 2023

SLOW-RELEASE METFORMIN FOR TREATING GESTATIONAL MELLITUS DIABETES IN PRESENCE OF LANGUAGE BARRIERS: EVIDENCE FROM THE FIRST STUDY IN ITALY AFTER ITS AUTHORIZATION IN PREGNANCY

Damiana Cavallaro Elisabetta Stucchi Anna Maria Veronelli Rossella Prospero Lucrezia Loda Chiara Dossi Anna Maria Marconi Stefania Triunfo
Department of Obstetrics and Gynecology, Milan, Italy, Asst Santi Paolo E Carlo, S. Paolo University Hospital, Universita' Degli Studi Di Milano,, Milan

Problem statement

Gestational diabetes mellitus (GDM) represents an open challenge for specialists in feto- maternal medicine, mainly due to short- and long-term risks for the mother-baby dyad. The aim of this study is to explore the impact of slow-release metformin in GDM therapy in patients with poor compliance due to complete or partial language barrier (LB). Study population was classified according to the language barrier, as absent, partial or complete.

Methods

A prospective study was designed including pregnant women affected by GDM. Data were collected about demographics, pregnancy course, maternal and fetal outcomes, glycemic control, and therapeutical approach. One-way analysis of variance (ANOVA) with post-hoc Bonferroni correction for multiple comparisons and Pearson`s chi-square test were used to test the hypothesis of linear trend in the study groups for quantitative and qualitative variables, respectively. Statistically significant p-value was set at <0.05.

Results

A total of 54 pregnancies were included in the analysis (absent LB, n=27; partial LB, n=12; complete LB, n=15, respectively). Statistical differences were found among study groups in ethnicity, education level, working status, and marital status, where similar maternal age and BMI at diagnosis were found. Fig. 1 and Fig 2 reports the distribution of maternal glycemic control at diagnosis and at the end of the pregnancy, and the request adjustments of therapy over the time. No statistically significant difference was found in perinatal outcomes. Of interest, no difference was found in placental weight, ratio between placental weight and birthweight and metabolic scaling low.

Conclusion

The management of GDM by slow-release metformin in GDM therapy in patients with poor compliance due to complete or partial language barrier seems promising in terms of optimal compliance by patients, favorable perinatal outcomes and impact on placental structure and function.

Keywords: Pregnancy, diabetes, placenta, metformin, insulin, language barrier.