Insulin is typically the first line of treatment for pregnant patients with Type 2 diabetes. This funding allows researchers to evaluate whether insulin combined with metformin leads to better outcomes for the mother and child.Researchers at the University of Alabama at Birmingham have been awarded an $8 million R01 grant from the National Institute of Diabetes and Digestive and Kidney Diseases to better understand the long-term health of children exposed to metformin during pregnancy. Metformin is a medication used to treat Type 2 diabetes during pregnancy.
Insulin is typically the first line of treatment for pregnant patients with Type 2 diabetes. This funding allows researchers to evaluate whether metformin combined with insulin leads to better outcomes for the mother and child. Prior studies have shown that this combination does not reduce neonatal complications including preterm birth and neonatal hypoglycemia, but it does reduce the odds of a large-for-gestational-age infant. These findings are important, because large-for-gestational-age infants can lead to an increased risk of C-sections, birth trauma and hypoglycemia for the baby.
“Pregnant women with Type 2 diabetes are at an increasingly high risk of maternal and infant complications,” said Ashley Battarbee, M.D., associate professor in the UAB Department of Obstetrics and Gynecology, director of the Center for Research in Women’s Health and principal investigator of the study. “Families want to know how this treatment impacts pregnancy outcomes and what this means for the child’s long-term health.”
This funding will be used to expand upon the MOMPOD trial, which stands for the Medical Optimization and Management of Pregnancies with Overt Type 2 Diabetes. The goal of the MOMPOD trial was to find the best medication to treat Type 2 diabetes in pregnancy.
Insulin helps control glucose levels in pregnant patients without crossing the placenta, while metformin crosses the placenta. With this funding, researchers will examine the long-term effects of metformin exposure on children whose moms were first enrolled in the MOMPOD trial. This study will assess the long-term outcomes of these children at age 10, including the child’s risk of obesity and their overall cardiometabolic health.
“While it is important to manage blood sugar to prevent fetal overgrowth and associated complications, we don’t know if there is a long-term benefit to the children when women are prescribed metformin in addition to insulin,” said Paula Chandler-Laney, Ph.D., a professor in the UAB Department of Nutrition Sciences and a co-PI of the study. “The parent study showed not much benefit from adding metformin, and there are a few small studies with data showing that children of women given metformin have more body fat. If we have similar results, with either no difference or more body fat in the children of women who received metformin, then together, the data from the parent study and this follow-up may urge providers to reconsider whether metformin is needed in pregnancy.”
“The MOMPOD follow-up study presents a unique opportunity to rigorously follow and assess the health of children exposed to metformin before they were born,” said Jeff Szychowski, Ph.D., co-PI and chair of the Department of Biostatistics in the UAB School of Public Health. “The UAB DATA coordinating and Collaborative Research Unit is excited to work with the exceptional team at UAB and our collaborative partners across the country to collect, manage and analyze data for this important project.”
Researchers at 17 centers across the United States will collect data on participants’ body mass index, the amount of excess body fat and cardiometabolic health, including cholesterol levels, glucose levels and blood pressure. Participants will wear continuous glucose monitors to see if there are any changes in glucose levels with meals or other activities. Researchers will conduct surveys to understand the impact of diet, physical activity/exercise and their environment.
The Center for Research in Women’s Health at UAB is dedicated to improving health outcomes for women and their children across all life stages through innovative, interdisciplinary research. Learn more here.