Metformin to Treat Corticosteroids-induced Hyperglycemia

Summary

Antenatal corticosteroids, particularly, betamethasone is routinely administered to pregnant women at risk for preterm delivery to improve neonatal outcomes. Although antenatal betamethasone was shown to induce both maternal hyperglycemia and neonatal hypoglycemia, to date, there is insufficient data to establish whether treatment for maternal hyperglycemia, particularly, metformin, will decrease the risk for neonatal hypoglycemia, particularly of preterm neonates. In the present study the investigators will examine the effect of treatment with metformin on maternal glycemic control and hypoglycemia in preterm neonates following maternal betamethasone treatment.

Timeline

Start

2020-07-05

Primary completion

2024-07-07

Completion

2025-05-05

Outcome

Met primary endpoint

paper Mean (SD) maternal total and postprandial glucose values were significantly lower in the metformin group (121 [15] vs 127 [17] mg/dL; P = .01 PMID 41511771 ↗

paper Neonatal hypoglycemia rate was lower in the metformin group (10 [21%] vs 23 [40%]; P = .04; relative risk, 0.53; 95% CI, 0.28-0.99). PMID 41511771 ↗

Publications

• Yefet E, Massalha M, Talmon G, Labay A, Matanis M, Sleman E, Nassra R, Frank Wolf M, Sgayer I, Lowenstein L, Nachum Z. Metformin, Maternal Glycemic Control, and Neonatal Hypoglycemia After Antenatal Steroids: A Randomized Clinical Trial. JAMA Netw Open. 2026 Jan 2;9(1):e2552807. doi: 10.1001/jamanetworkopen.2025.52807.

Drugs

Evaluation	Drug	Modality	Dose	Route
Subject	Metformin	Small molecule	425 mg	—
Subject	Metformin	Small molecule	1700 mg	—

Indications