Finding an alternative to metformin for gestational diabetes: The GUARD trial

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.
  • Author's list

    Professor Catherine Williamson, Professor Helen Murphy, Dr Caroline Ovadia, Dr Alice Mitchell, Dr Peter Dixon, Holly Lovell, Professor Kennedy Cruickshank, Sonia Sorrano, Noellia Pitrelli, Dr Sara White, Dr Anita Banerjee, Paul Seed

    Start date: 2020
    End date: 2022

  • Research centre

  • Research status

    Ongoing projects

Why do we need this research?

Diabetes diagnosed in pregnancy – known as gestational diabetes – affects around 35,000 women in the UK every year. These women are more likely to experience pregnancy complications such as pre-eclampsia, premature birth and stillbirth, and there is also an increased risk of their babies having obesity, cardiovascular disease or type 2 diabetes in later life. Metformin is a drug that is often used to treat gestational diabetes, but it isn’t always effective. We urgently need to find new ways of treating gestational diabetes to help reduce the risks for babies.

What’s happening in this project?

Ursodeoxycholic acid (or UDCA for short) is a drug that is currently used to treat another pregnancy complication called intrahepatic cholestasis in pregnancy. Researchers supported by Tommy’s have carried out some work that has suggested that UDCA might also be a useful treatment for gestational diabetes, and they want to look into this further. As UDCA works in a different way to metformin, it is possible that it may be a better option for controlling gestational diabetes, thus reducing the chances of complications for both mother and baby.

Our researchers are now setting up the GUARD trial to find out how effective UDCA is in treating gestational diabetes, compared to metformin. In the trial, women will be given either UDCA or metformin to treat their condition. The team will compare how well the two drugs are able to control blood glucose levels and will also find out whether treatment with UDCA improves outcomes for babies, for example, by reducing the number of babies who grow too fast in the womb. 

As well as this trial, our researchers will carry out work in the lab to find out more about how UDCA and metformin work.

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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