Controversies in metformin use in pregnancy and the role of triglycerides in fetal overgrowth

Preemptive, early-life strategies beginning in utero that reduce risk for childhood obesity are imperative to arrest the intergenerational cycle of diabetes and metabolic disease including childhood obesity and non-alcoholic fatty liver disease (NAFLD).  Metabolic factors as well as drugs that cross...

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Main Author: Linda Barbour
Format: Article
Language:Spanish
Published: Sello Editorial Lugones 2022-09-01
Series:Revista de la Sociedad Argentina de Diabetes
Subjects:
Online Access:https://revistasad.com/index.php/diabetes/article/view/629
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author Linda Barbour
author_facet Linda Barbour
author_sort Linda Barbour
collection DOAJ
description Preemptive, early-life strategies beginning in utero that reduce risk for childhood obesity are imperative to arrest the intergenerational cycle of diabetes and metabolic disease including childhood obesity and non-alcoholic fatty liver disease (NAFLD).  Metabolic factors as well as drugs that cross the placenta can create an intrauterine environment with profound effects on prenatal development and enhanced susceptibility to later chronic disease.  In the first part of this talk we take a close look at metformin, widely used to treat GDM but an agent in which fetal concentrations are higher than maternal and concentrated 1000-fold in fetal and placental mitochondria due to organic cation transporters.  We review metformin’s multitude of intracellular effects including its anticancer effects, growth inhibitory properties, and suppression of mitochondrial respiration.  We also review data from the Metformin in Gestation (MiG) and PCOS RCTs which randomized pregnant women to metformin, and which found an increased risk of childhood overweight at 5-10 years1,2.  We will discuss how the growth inhibiting properties of metformin appear to increase the risk for small-for-gestational-age (SGA) infants, also a risk factor for subsequent childhood obesity, demonstrated recently in the MiTY RCT in which metformin was added to insulin for Type 2 diabetes.
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spelling doaj.art-0aee6447038944398b7128c785d45bd62022-12-22T04:39:03ZspaSello Editorial LugonesRevista de la Sociedad Argentina de Diabetes0325-52472346-94202022-09-01563Sup909010.47196/diab.v56i3Sup.629543Controversies in metformin use in pregnancy and the role of triglycerides in fetal overgrowthLinda Barbour0Profesora de Medicina Materno Fetal y Endocrinología, Facultad de Medicina de la Universidad de Colorado, Estados UnidosPreemptive, early-life strategies beginning in utero that reduce risk for childhood obesity are imperative to arrest the intergenerational cycle of diabetes and metabolic disease including childhood obesity and non-alcoholic fatty liver disease (NAFLD).  Metabolic factors as well as drugs that cross the placenta can create an intrauterine environment with profound effects on prenatal development and enhanced susceptibility to later chronic disease.  In the first part of this talk we take a close look at metformin, widely used to treat GDM but an agent in which fetal concentrations are higher than maternal and concentrated 1000-fold in fetal and placental mitochondria due to organic cation transporters.  We review metformin’s multitude of intracellular effects including its anticancer effects, growth inhibitory properties, and suppression of mitochondrial respiration.  We also review data from the Metformin in Gestation (MiG) and PCOS RCTs which randomized pregnant women to metformin, and which found an increased risk of childhood overweight at 5-10 years1,2.  We will discuss how the growth inhibiting properties of metformin appear to increase the risk for small-for-gestational-age (SGA) infants, also a risk factor for subsequent childhood obesity, demonstrated recently in the MiTY RCT in which metformin was added to insulin for Type 2 diabetes.https://revistasad.com/index.php/diabetes/article/view/629metforminaembarazo
spellingShingle Linda Barbour
Controversies in metformin use in pregnancy and the role of triglycerides in fetal overgrowth
Revista de la Sociedad Argentina de Diabetes
metformina
embarazo
title Controversies in metformin use in pregnancy and the role of triglycerides in fetal overgrowth
title_full Controversies in metformin use in pregnancy and the role of triglycerides in fetal overgrowth
title_fullStr Controversies in metformin use in pregnancy and the role of triglycerides in fetal overgrowth
title_full_unstemmed Controversies in metformin use in pregnancy and the role of triglycerides in fetal overgrowth
title_short Controversies in metformin use in pregnancy and the role of triglycerides in fetal overgrowth
title_sort controversies in metformin use in pregnancy and the role of triglycerides in fetal overgrowth
topic metformina
embarazo
url https://revistasad.com/index.php/diabetes/article/view/629
work_keys_str_mv AT lindabarbour controversiesinmetforminuseinpregnancyandtheroleoftriglyceridesinfetalovergrowth