Effects of Diet and Metformin on placental morphology in Gestational Diabetes Mellitus

Rabia Arshad; Muhammad Adnan Kanpurwala; Nasim Karim; Jahan Ara Hassan

doi:10.12669/pjms.326.10872

Effects of Diet and Metformin on placental morphology in Gestational Diabetes Mellitus

Pak J Med Sci. 2016 Nov-Dec;32(6):1522-1527. doi: 10.12669/pjms.326.10872.

Authors

Rabia Arshad¹, Muhammad Adnan Kanpurwala², Nasim Karim³, Jahan Ara Hassan⁴

Affiliations

¹ Dr. Rabia Arshad, MBBS, M. Phil. Assistant Professor and Head of Pharmacology Department, Altamash Institute of Dental Medicine, 2-R Sunset Boulevard, DHA, Karachi, Pakistan.
² Dr. Muhammad Adnan Kanpurwala, MBBS, M. Phil. Associate Professor, Physiology Department, Karachi Institute of Medical Sciences, Karachi, Pakistan.
³ Dr. Nasim Karim, MBBS, M. Phil, Ph D, Post Doc. Professor and Head of Pharmacology Department, Bahria University Medical and Dental College, Karachi, Pakistan.
⁴ Dr. Jahan Ara Hasan, MBBS, FCPS, MCPS. Associate Professor, Gynecology and Obstetrics Department, Dow University of Health Sciences, Karachi, Pakistan.

Abstract

Objective: To evaluate the effects of diet control and Metformin on placental morphology in gestational diabetes mellitus (GDM).

Methods: After written informed consent 62 GDMs were enrolled. According to WHO criteria, 30 cases of GDMs with blood sugar level <130 mg/dl, were assigned Group B (2000-2500Kcal/day and 30 minute walk thrice weekly were kept on diet control and 32 cases of GDM with blood sugar level >130 mg/dl, assigned Group C were kept on diet with tablet Metformin,(500mg TDS) Finally 25 normal pregnant females were kept in Group A as control. After delivery placentae were preserved and evaluated for morphology.

Results: Heavy placentae with abundant villous immaturity, chorangiosis and syncytial knots in group B and fibrinoid necrosis and calcification in group C were seen. In group B versus A placental and cord width while in Group C versus A only cord width in gross morphology showed significant results. In group B versus A villous immaturity, chorangiosis, infarction and syncytial knots in light microscopy were present; similarly in B versus C placental width, chorangiosis and syncytial knots showed significant results, while in C versus A results were non-significant.

Conclusion: Metformin produced beneficial effects on placental morphology being comparable to normal control in contrast to diet group.

Keywords: Diet; Exercise; Gestational diabetes; Gross morphology; Metformin; Microscopic morphology; Placenta.