Impact of Medical Nutrition Therapy, Metformin, and Insulin on Neonatal Outcomes in Gestational Diabetes Mellitus: A Cross-Sectional Study

Abstract

Gestational diabetes mellitus (GDM) is associated with increased risks of adverse neonatal outcomes. This cross-sectional study aimed to evaluate and compare the effects of medical nutrition therapy (MNT), metformin, and insulin on neonatal outcomes in pregnancies complicated by GDM. Conducted at a tertiary care hospital, the study included pregnant women diagnosed with GDM who were managed with one of the three interventions based on glycemic control needs and clinical assessment. Neonatal outcomes assessed included birth weight, incidence of macrosomia, neonatal hypoglycemia, NICU admission, Apgar scores, and mode of delivery. Statistical analysis revealed that MNT was associated with the lowest incidence of adverse neonatal outcomes, while insulin-treated mothers had a higher frequency of macrosomia and NICU admissions. Metformin showed a favorable safety profile, with neonatal outcomes comparable to MNT and better than insulin in certain parameters. These findings suggest that MNT remains an effective first-line management strategy, while metformin may be a viable alternative to insulin in selected GDM cases with fewer neonatal complications.