Metformin’s Double-Edged Sword: Protecting Moms but Impacting Babies

A new study from the German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE) has shed light on the complex impacts of the popular diabetes drug metformin during pregnancy.

While the research team found that metformin can have positive effects for the mother, it may not yield the same benefits for the offspring.

Metformin, an oral antidiabetic agent, has become increasingly common in the treatment of gestational diabetes, a type of diabetes that develops during pregnancy. However, the long-term effects of metformin exposure on the child’s brain development have remained largely unknown.

“As a result of antidiabetic treatment in the early postnatal period, we were able to identify alterations in the weight gain and hormonal status of the offspring, which were critically dependent on the metabolic state of the mother,” explains Dr. Rachel Lippert, the study’s lead author and a Junior Research Group Leader at DIfE.

The researchers used mouse models to represent the two main causes of gestational diabetes: severe obesity before pregnancy and excessive weight gain during pregnancy. They then treated the female mice and their offspring with either insulin, metformin, or a placebo during the lactation period, which corresponds to the third trimester of human pregnancy.

The findings suggest that while metformin may be beneficial for the mother, it does not necessarily translate to positive outcomes for the child. In fact, the study observed sex-specific changes in the signaling pathways of the hypothalamus, a critical brain region for regulating energy homeostasis, in response to metformin exposure.

“Together with the metformin-induced shift in the examined hormone levels, the results indicate that the maternal metabolic state must be taken into account before starting the treatment of gestational diabetes,” Lippert says.

The researchers emphasize the importance of focusing on preventive measures and proactive management of gestational diabetes, rather than relying solely on medications that may have unintended consequences for the developing child.

“Given the increasing prevalence, education about gestational diabetes and preventive measures are of vital importance. If we can find a way to manage lifestyle and diet more proactively, we are in a better position to exploit the potential of gestational diabetes treatment,” Lippert adds.

As the use of metformin during pregnancy continues to rise, this study underscores the need for a more comprehensive understanding of the long-term impacts on both maternal and child health. The findings encourage a cautious and personalized approach to gestational diabetes management, prioritizing prevention and considering the specific metabolic state of the mother.

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