Efficacy of metformin in a patient with prediabetes in the framework of pregravity preparation

Abstract

Prediabetes is often detected in young women planning pregnancy. The effectiveness of metformin in normalizing metabolic and hormonal parameters in a woman with prediabetes was assessed. Patient H., 33 years old, with obesity and high blood pressure (BP), is planning pregnancy. Obesity for 6 years, weight gain of 7 kg during the year, menstrual cycle irregularities, BP up to 150/90 mm Hg. Waist circumference (WC) 98 cm, hip circumference (HC) 86, WC/HC 1.1, height 166 cm, weight 84 kg, body mass index (BMI) 30.5 kg/m², BP 140/85 mm Hg, venous plasma glucose 6.2 mmol/l. The patient has hyperinsulinemia, insulin resistance and dyslipidemia. Against the background of a hypocaloric diet and increased physical activity, metformin 1000 mg was prescribed with an assessment of metabolic and hormonal disorders after 6 and 12 months. After 12 months, weight was 69 kg (-15 kg), WC 77 cm (-13 cm), BMI 25 kg/m² (-5.5 kg/m2), HOMA-IR 0.87 (-4.83), BP 110/70 mmHg, TG 0.9 mmol/l (-1.0), LDL-C 1.7 mmol/l (-1.6), HDL-C 1.3 mmol/l (+0.4), venous plasma glucose 4.0 mmol/l, insulin 4.9 μU/ml. Normalization of hormones: LH 5.7, FSH 3.8 IU/l, LH/FSH 1.5, testosterone 1.2 nmol/l. Regular menstrual cycle after 6 months. Metformin 1000 mg per day in a young patient with prediabetes against the background of a hypocaloric diet and increased physical activity effectively reduced body weight, normalized the insulin resistance index, metabolic and hormonal parameters necessary for pregnancy planning.