Primary Maternal Neonatal Outcome with MNT Metformin in Early Gestational Glucose Intolerance (EGGI)

Abstract

To explore the roles of Medical Nutritional Therapy (MNT) and Metformin in managing early gestational glucose intolerance (EGGI) with the potential to prevent the development of gestational diabetes mellitus (GDM) and reduce primary neonatal outcomes. Objectives: This important study examines the effectiveness of Medical Nutrition Therapy (MNT) and Metformin in managing early gestational glucose intolerance during the 8th to 10th week of pregnancy, specifically for postprandial blood glucose (PPBG) levels over or equal to 110 mg/dL. Materials and Methods: A prospective cohort study at the Upper India Sugar Exchange Maternity Hospital in Kanpur involved 231 pregnant women between the 8th and 10th weeks of gestation, all with a postprandial blood glucose (PPBG) level of 110 mg/dL or higher. Participants were randomly assigned to two groups: one received Medical Nutrition Therapy (MNT) combined with Metformin, while the other received MNT alone. Results: The results reveal that mean postprandial blood glucose (PPBG) levels were significantly lower in the Metformin + MNT group compared to the MNT group at key time weeks: 126.77 ± 6.55 vs. 134.1 ± 10.74 at 12 weeks, 122.95 ± 8.47 vs. 126.65 ± 13.2 at 16 weeks, 117.80 ± 4.91 vs. 124.76 ± 11.03 at 24 weeks, and 113.92 ± 8.94 vs. 127.71 ± 17.65 at 32 weeks, with all P-values ≤ 0.001. Additionally, the incidence of primary composite adverse neonatal outcomes was significantly higher in the MNT group (35 cases, 32.41%) than in the Metformin + MNT group (21 cases, 17.07%), with a P-value ≤ 0.0001. Conclusion: Recognizing and addressing Early Gestational Glucose Impairment (EGGI) as soon as possible, with the support of Medical Nutrition Therapy (MNT) and Metformin, can truly make a difference. This approach not only helps in preventing the progression to Gestational Diabetes Mellitus (GDM) and improving blood sugar control, but it can also lead to significantly better Neonatal outcomes. By taking this proactive step, we can provide a nurturing foundation for better Maternal fetal health, helping to set the stage for Diabetes Prevention.