taken from Vitaline board member...met - m/c

[Blakesmomma]

Diabetes Drug Helps Prevent Miscarriage

By Salynn Boyles
WebMD Medical News Reviewed By Charlotte Grayson, MD

March 1, 2002 -- A popular diabetes drug may hold the key to
motherhood
for millions of women with the most common form of infertility.
Miscarriage rates dropped dramatically among a group of women with
polycystic ovary syndrome (PCOS) treated with the drug metformin.

Researchers say the drug, also known as Glucophage, is also highly
effective in preventing gestational diabetes, a form of diabetes
that is
common in pregnant women with PCOS, and may be a better treatment
than
insulin for all women with pregnancy-related diabetes.

"This therapy is rapidly revolutionizing the treatment of
infertility,
and with good reason," says Charles Glueck, MD, who conducted some of
the first metformin infertility studies and has treated almost 1,500
women with the syndrome. "In women with PCOS the risk of miscarriage
is
very high, around 50%. By giving metformin, the risk is reduced to
that
of a woman without PCOS."

It is believed that up to 10% of Caucasian women in the U.S., and
15% of
Hispanic and black women have PCOS, although most have not been
diagnosed. Women with the syndrome often have irregular or absent
menstrual periods, elevated insulin levels (similar to people with
type
2 diabetes), and weight problems. Many women with PCOS do not
ovulate at
all, and those who get pregnant often have miscarriages.

Metformin is approved for treating type 2 diabetes, but it is being
used
off-label by an increasing number of infertility specialists to treat
PCOS-related infertility. Many doctors in the U.S. take women off the
drug once they become pregnant, but the new research suggests they
should keep taking it during pregnancy.

In a study published in the Journal of Clinical Endocrinology and
Metabolism, researchers reviewed the histories of 65 pregnant women
with
PCOS who were taking metformin prior to conception and throughout
their
pregnancy and 31 pregnant women with PCOS who did not take the drug.
The
women were patients at a fertility clinic in Caracas, Venezuela, and
they were treated over a four and a half year period.

Roughly 9% of the women who took the drug miscarried (six of 65),
compared with 42% of women who did not (13 of 31). Among the women in
each group who had a history of miscarriage, the rate of pregnancy
loss
was 11% for those receiving treatment and almost 60% for those not
treated. The research was funded by the National Institute of Child
Health and Human Development, a branch of the National Institutes of
Health.

The study offers the best evidence yet that metformin may be useful
for
the treatment of gestational diabetes, says lead author John E.
Nestler,
MD, of the Medical College of Virginia. Insulin sensitivity improved
for
the pregnant women on metformin, compared with their sensitivity
prior
to pregnancy when not taking the drug.

"Normally, insulin sensitivity gets worse during pregnancy, and that
is
why some women get gestational diabetes," Nestler tells WebMD. "We
found
just the opposite with these women. Insulin sensitivity actually got
better in the treated women. This is very exciting evidence that this
drug can be useful in preventing gestational diabetes."

Glueck, who is director of the Cholesterol Center in Cincinnati, is
presenting even stronger evidence in a study scheduled for
publication
in the March issue of the journal Fertility and Sterility. The
incidence
of gestational diabetes in that study was just 3% among pregnant
patients with PCOS taking metformin, compared with an incidence of
40%
for patients not taking the drug.

The findings, Glueck says, suggest that metformin may have a role in
preventing not just gestational diabetes, but type 2 diabetes that is
not related to pregnancy.

"We know that 80% of women who develop gestational diabetes with go
on
to develop type 2 diabetes," he says. "In fact, gestational diabetes
is
an accelerated model for how most people develop type 2 diabetes. The
fact that we can reduce the incidence of gestational diabetes in
PCOS so
dramatically tells us that metformin may reduce the risk of diabetes
in
other high-risk people."

© 2002 WebMD Inc. All rights reserved.