Gestational diabetes mellitus and metformin: A case series: Our experience in a secondary health centre in Lagos, Nigeria

The global prevalence of Gestational Diabetes Mellitus (GDM) is 1-28%, with its highest prevalence amongst low- and middle-income countries. In Nigeria, the prevalence ranges between 0.5-38% with a pool prevalence of 11%. The World Health Organisation (WHO) in 2013 reviewed different studies, including the IADPSG recommendations, and following that, it named abnormalities of glucose intolerance noticed while pregnant as “Hyperglycaemia first detected at any time during pregnancy” and called it Hyperglycaemia in Pregnancy (HIP) which was divided into Diabetes Mellitus in pregnancy (DIP) and Gestational Diabetes Mellitus (GDM). The management of HIP which includes GDM as recommended by WHO (2013), recommends a stepwise approach that starts with lifestyle modification and then to use insulin if needed. This is the practice globally, however, there is increasing use of metformin in managing GDM with favourable outcomes. Our facility is in a suburban, resource-poor area of Lagos, and we have had to treat mothers with GDM with metformin. To increase and improve knowledge on the use of metformin, we reviewed the case files of these patients. Within the year under review, eleven patients were diagnosed with GDM using the IADPSG criteria and were all treated solely with metformin. The average age of these women was 34.18 ± 5.42 years, and the average weight of these mothers was 100.15 ± 5.62kg, the average birth weight was 3.21 ± 0.34kg, with one baby (9.09%) having birth trauma injuries, 2 babies (18.18%) were diagnosed with mild asphyxia and they were all delivered at term.