A CLINICAL TRIAL ON THE EFFECTIVENESS OF METFORMIN, EXERCISE & DIET ON GESTATIONAL DIABETES MELLITUS (GDM) PATIENT'S PLACENTAL MORPHOLOGY

Objective: Our research objective was to assess the Metformin and diet control effects in placental morphology during GDM (Gestational Diabetes Mellitus).

Methods: Our research was carried out on sixty patients at Mayo Hospital, Lahore (March 2016 to February 2017). We enrolled sixty GDM cases after taking their written approval for participation. As per the guidelines of WHO groups were made like that in A group thirty cases having level of blood sugar (< 130 mg/dl) and B group patients were included with an intake of (2000 – 2500) Kilo calorie per day with thrice thirty-minute walk were included having level of blood sugar (>130 mg/dl). Group C was given Metformin tablets during the diet period. Group A also held twenty-five normal cases who were pregnant as controls. We evaluated placental after delivery.

Results: Heavy placentae having ample chorangiosis, villous immaturity and syncytial knots in calcification and group Band fibrinoid necrosis were seen in C group. In “B Vs A” and “C Vs A” respectively we observed “cord and placental width” and “cord width” in the outcomes of gross morphology. “B Vs A” group was seen with chorangiosis, villous immaturity, syncytial knots and infarction in light microscopy; similarly, in group “B Vs C” chorangiosis, placental width and syncytial knots with significant outcomes; whereas, in group “C Vs A” non-significant outcomes were observed.

Conclusion: Beneficial outcomes were received with the use of Metformin on the placental morphology which can be compared with the outcomes of normal controls contrary to the cases on diet.

Keywords: Diet, Gestational Diabetes Mellitus (GDM), Exercise, Placenta, Metformin, Microscopic Morphology and Gross Morphology.