Intermittent metformin (Glucophage) is non-inferior to continuous metformin for prediabetes in post-partum women with prior gestational diabetes mellitus

1. Among women with prediabetes following prior gestational diabetes mellitus (GDM), intermittent metformin (Glucophage) in combination with lifestyle modifications was non-inferior to continuous metformin in combination with lifestyle modifications. 

Evidence Rating Level: 1 (Excellent)

Women with GDM are at a significantly increased risk of developing type 2 diabetes mellitus (T2DM) postpartum compared to those without GDM. Current American guidelines recommend either lifestyle modifications or metformin treatment for women with a history of GDM and post-partum prediabetes. This randomized controlled trial therefore sought to investigate whether an intermittent metformin regimen is non-inferior to continuous metformin in preventing T2DM occurrence. 334 postpartum women with prediabetes from several medical centres in China were included in this study for randomization (167 in the continuous metformin group and 167 in the intermittent metformin group) and completed the 3-year follow-up as per protocol. In the intention-to-treat analysis, the incidence of T2DM was similar across both groups (11.1% [95% CI: 6.5-15.7%] for the continuous metformin group compared to 11.5% [95% CI: 6.6-16.4%] for the intermittent metformin group) and met the pre-specified non-inferiority margin. Under the per protocol analysis, the incidence of T2DM was also similar across both groups and similarly met the pre-specified non-inferiority margin (10.2% [95% CI: 6.5-15.7%] for the continuous metformin group compared to 10.8% [95% CI: 6.9-16.4%] for the intermittent metformin group). Overall, this study found that among postpartum women with prediabetes, the use of an intermittent metformin regimen resulted in similar efficacy compared with a continuous metformin regimen in preventing T2DM. 

Click here to read the study in BMC Medicine

Image: PD

©2026 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.