PCOS/Metformin & Gestational Diabetes advice

[junebuglb]

Currently 10wks with my first baby and I’m hoping someone might be able to help with my confusion around Metformin/GD in pregnancy.

Ahead of TTC, I was prescribed Metformin to help regulate my cycles and some other symptoms of PCOS eg insulin resistance. We successfully conceived and I have now been taking Metformin for a good few months and have continued whilst pregnant.

My first question is whether I should continue to take the Metformin during the rest of my pregnancy. I asked this at my booking appointment and was told that because I was prescribed privately I need to go and pay for another private appointment and ask there. So… if needs must, I of course will do this. But surely there is someone I can talk to on NHS without having to drop £200 on a two minute phone call? Has anyone continued metformin, or did you stop, who did you ask?

Secondly, I’m really confused as to what happens around the GD test when taking Metformin. At my booking appointment I was offered the glucose test at 28wks; I was given the option but not pushed or even nudged to accept/decline. But my mum has a history of GD which i mentioned at the appt. It’s my understanding that if I do accept the test, I will need to stop taking Metformin, stay off it to take the test, but then if I do have GD, I’ll need to start taking it all over again. Metformin seems to have no negatives during pregnancy but it definitely takes some time to adjust to, so I’m not keen to stop/start without good reason. The side effects have previously taken weeks to manage.

So… I guess I want to know is could I just keep taking the Metformin and not have the GD test? Or is that irresponsible? And who the heck do I ask if a midwife doesn’t know? I have an appt in a couple of weeks at my 12 week scan so am hoping to get some answers then, but don’t want to be pushed into an uninformed decision. Has anyone had personal experience with this? Thanks!

I was told to stop at 12 weeks. I developed GD diagnosed at 28 weeks in one pregnancy but not the other. I was put on insulin for GD.

I have PCOS and took Metformin to help conceive alongside Clomid and was told that once I finished the first trimester, I no longer needed to take it, but equally it was fine to use up the prescription I had (which took me up to 14 weeks)

Congratulations on your pregnancy and I hope you have a happy healthy time! 💖

I was tested at 16 weeks for GD due to both parents having Type 2 diabetes. I have been checking my blood for the last couple of weeks and it was concluded that I needed treatment as my fasting readings were consistently on the high side. First line of treatment is metformin but I asked to be put on insulin instead as it doesn't cross the placenta as opposed to metformin and some studies have found that babies later on in life tend to have more issues with their weight and more at risk to develop T2 diabetes as adults if the mother was on metformin during pregnancy. I chose to be on the safe side.

Thanks all so much for the info this is interesting to know @Hana89 @TTCbaby2023 @Thisusernamenotavailable x

@Hana89 that’s so good to know, thanks so much! If you don’t mind can I ask how your pregnancy went, did you accept the GD test?
I think I might be overthinking coming off the metformin, but maybe it’s the right call to come off it. I just want to do the “right” thing for the babe and worry my blood sugar will go bonkers if I stop!

I have PCOS and was taking Metformin before conceiving. Asked at my midwife appointment if I should keep taking it and was told it was fine either way. I've stopped taking it for now as have enough to take with the pre-natal vitamins. Doesn't appear to have caused any problems not taking it.

@junebuglb my pregnancy was textbook perfect after a series of early losses. Alice is 9 months old and just the most perfect little girl.
I accepted the GD test, but I don't have a family history of it, and I have to admit, it really wasn't a worry for me. I would say though, if their is a family history of GD/type 1 or 2 D for you I think I would prioritise monitoring that and not worry too much about Metformin unless specifically advised to keep taking it.
Good luck! Xx

@junebuglb just to add - my previous miscarriages were due to low progesterone. Nothing to do with Metformin! Xx

@TryingForBabyFirstTime that’s so reassuring to know, thank you! It is a lot of tablets every day. Best of luck with the rest of your pregnancy! 💕

@Hana89 ohhhh this is so nice to hear, thankyou you’ve really put my mind at ease! I’ll definitely mention this at my next appt regardless and think it’s probs the right call to accept the test.
Thanks a million & congrats on your lovely girl 🥰