GUARD – finding an alternative to metformin for gestational diabetes

Prof Catherine Williamson, Prof Helen Murphy, Dr Caroline Ovadia, Dr Annette Briley, Ms Claire Singh, Dr Peter Dixon, Prof Kennedy Cruickshank, Ms Sonia Sorrano

Diabetes diagnosed during pregnancy is often treated with metformin, but the drug isn’t always effective. Our researchers have set up a trial to test whether a different drug might be more effective at preventing health complications for mother and baby.

Why do we need this research?

Diabetes diagnosed in pregnancy – known as gestational diabetes – affects around 35,000 women in the UK every year. It can sometimes lead to health problems for both mother and baby, including pre-eclampsia, premature birth, and stillbirth. Metformin is a drug often used to treat gestational diabetes, but it isn’t always effective. We urgently need to find new ways to treat gestational diabetes and help reduce the risks for babies.

What’s happening in this project?

A drug called ursodeoxycholic acid (or UDCA for short) is currently used to treat another pregnancy complication called intrahepatic cholestasis in pregnancy. Previously, researchers supported by Tommy’s have found that UDCA might also be a useful treatment for diabetes. Because UDCA works in a different way to metformin, it could potentially provide another option for controlling gestational diabetes.

Our researchers are setting up the GUARD trial to see how effective UDCA is in treating diabetes, compared to metformin. In the trial, women with gestational diabetes will be recruited from three NHS hospitals, and given either UDCA or metformin to treat their condition. The team will study how the drugs compare in controlling blood glucose levels, and will also study what effect they have on complications for the baby, such as growing too fast in the womb.

What difference will this project make?

This study will find out if UDCA could be used instead of metformin to treat diabetes during pregnancy. If successful, this could provide an alternative that doctors can use to help reduce the risks of the condition for both mother and baby.

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