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Background <p>Recent guidelines have introduced the concept of early gestational glucose intolerance (EGGI), necessitating timely intervention to prevent GDM and its complications.</p> Objective <p>&#xa0;This study aimed to evaluate whether early intervention with medical nutritional therapy (MNT) and metformin in women with postprandial blood glucose (PPBG) ≥ 110&#xa0;mg/dl at 8–9&#xa0;weeks gestation (EGGI) could reduce the progression to GDM and associated complications.</p> Methods <p>This prospective, longitudinal study included pregnant women with singleton pregnancies and PPBG ≥ 110&#xa0;mg/dl &lt; 9&#xa0;weeks gestation. Participants were divided into two groups: the intervention group (MNT + Metformin 250&#xa0;mg twice daily) and the control group (MNT only).</p> Results <p>Metformin group had a significant reduction in PPBG levels by 11&#xa0;weeks (<i>p</i> &lt; 0.0001) thus preventing fetal hyperinsulinemia. Only 2.6% in metformin vs. 87.0% in controls developed GDM (<i>p</i> &lt; 0.0001). Additionally, maternal and fetal complications, including hypertension (<i>p</i> = 0.034), preterm delivery <i>(p</i> &lt; 0.0001), macrosomia (<i>p</i> &lt; 0.0001), and neonatal hypoglycemia (<i>p</i> &lt; 0.019), were also significantly reduced by adding metformin to MNT.</p> Conclusion <p>Early intervention with metformin and MNT significantly reduces the risk of GDM and adverse fetomaternal outcomes. These findings support the inclusion of early glucose screening and metformin therapy in clinical guidelines to prevent GDM and promote optimal pregnancy outcomes. Future research should explore long-term benefits and refine strategies for primordial prevention of diabetes.</p>

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Intervening early: a strategy to prevent gestational diabetes mellitus by treating early gestational glucose intolerance (EGGI) with medical nutrition therapy and metformin

  • 期刊论文

  • 发表日期：

    2026年4月1日

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  • Pikee Saxena,
  • Vidya Singarupam,
  • Reena Yadav,
  • Sushma Nagia,
  • Anjalakshi C.,
  • Rajeev Chawla,
  • V. Seshiah

摘要

Background

Recent guidelines have introduced the concept of early gestational glucose intolerance (EGGI), necessitating timely intervention to prevent GDM and its complications.

Objective

 This study aimed to evaluate whether early intervention with medical nutritional therapy (MNT) and metformin in women with postprandial blood glucose (PPBG) ≥ 110 mg/dl at 8–9 weeks gestation (EGGI) could reduce the progression to GDM and associated complications.

Methods

This prospective, longitudinal study included pregnant women with singleton pregnancies and PPBG ≥ 110 mg/dl < 9 weeks gestation. Participants were divided into two groups: the intervention group (MNT + Metformin 250 mg twice daily) and the control group (MNT only).

Results

Metformin group had a significant reduction in PPBG levels by 11 weeks (p < 0.0001) thus preventing fetal hyperinsulinemia. Only 2.6% in metformin vs. 87.0% in controls developed GDM (p < 0.0001). Additionally, maternal and fetal complications, including hypertension (p = 0.034), preterm delivery (p < 0.0001), macrosomia (p < 0.0001), and neonatal hypoglycemia (p < 0.019), were also significantly reduced by adding metformin to MNT.

Conclusion

Early intervention with metformin and MNT significantly reduces the risk of GDM and adverse fetomaternal outcomes. These findings support the inclusion of early glucose screening and metformin therapy in clinical guidelines to prevent GDM and promote optimal pregnancy outcomes. Future research should explore long-term benefits and refine strategies for primordial prevention of diabetes.