Me-D-Links: metformin for diabetes in pregnancy – an analysis of health and education outcomes using linked administrative data
By looking at prescribing records, mother and child health records, educational records and census data from across the UK, this study will compare pregnant women and their children who were exposed to metformin with those who were not.
Type 2 diabetes and gestational diabetes, which develops during pregnancy, are increasingly common, affecting up to 18% of pregnancies. The findings of this research will help women and their health care providers make more informed decisions about their care.
This project will use datasets from the NHS, the Department for Education and ONS.
More about the project
Type 2 diabetes and gestational diabetes (GDM), diabetes which develops during pregnancy, are increasingly common affecting up to 18% of pregnancies. Traditionally insulin has been considered the ‘gold standard’ for the treatment of diabetes in pregnancy. However, the 2015 National Institute of Health and Care Excellence Diabetes in Pregnancy Guideline recommends metformin, an oral blood glucose lowering drug, for those with GDM. In those with type 2 diabetes the guideline states that metformin may be used when the likely benefits outweigh the potential for harm. The routine use of metformin in GDM is controversial. Metformin has been shown to cross the placenta and we do not know if it affects the growth or long term development of children who were exposed in the womb. With increasing numbers of women in the UK taking metformin during their pregnancy more research is needed to determine its potential harms or benefits.
As metformin is not commonly used in pregnancy, and some of the pregnancy complications in which we are interested are rare, we need to use data from as large an area as possible. Through the Administrative Data Research Network (ADRN) we will get access to prescribing records, mother and child health records, educational records and census data, from the 4 regions of the UK. The outcomes among pregnant women, or infants, who were exposed to metformin will then be compared to those who were not.
The findings of this research will help women and their health care providers make more informed decisions about their care. We will work with charities and patient organisations to disseminate the findings of the research to women who are pregnant or thinking of becoming pregnant.
As one of the first, if not the first, projects conducted within the ADRN using data from all 4 regions of the UK this project will help to clarify the processes involved. This will assist in the design and conduct of future UK wide ADRN projects.
Date approved: July 2016
Dr Joanne Given, Institute of Nursing and Health Research, Ulster University
Professor Vivien Coates, Institute of Nursing and Health Research, Ulster University
Professor Brendan Bunting, Psychology Research Institute, Ulster University
Dr Maria Loane, Institute of Nursing and Health Research, Ulster University
Dr Ester Garne, Paediatric Department, Hospital Lillebaelt
Dr Una O’Connor Bones, Institute for Research in Social Sciences, Ulster University
Professor David McCance, Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital
Professor Helen Dolk, Institute of Nursing and Health Research, Ulster University