PCOS, Metformin and the OGTT

[Mummato2]

Hi Guys,

I have butted heads with my OB and wanted a few opinions.

I have PCOS and am on Metformin. In my last pregnancy, my Endocrinologist expressly told me to stay on it as it prevents GD - which it did with my first pregnancy I tested my BSL daily and it was always perfect.

This pregnancy I refused an OGTT because Metformin will mask the result. My OB told me to come off it for 48 hours and then to take the test and not restart it again until I saw her for the results.

I am not comfortable with this because her plan is if I "fail" the test, she will put me on insulin and I can't for the life of me see how coming off a drug designed to prevent me going on insulin in the first place is a great plan.

PLUS I trust my Endrocrinologist (Warren Kidson) who has done so much ground breaking research when it comes to PCOS and Metformin use.

I still do my BSL's daily - so can't see why she wants this OGTT - to me it almost seems that she is uncomfortable with the drug I am on because she hasn't seen many women take it and she'd rather manage the issue with something she is familiar with but not necessarily the best option

My question is if I refuse the test and flatly refuse the management my OB is suggesting, can she stop providing me with care? Or does she just note it as "against medical advice"?

Anyone had experience with this or anything similar and how did you approach it? I have about 5 recent medical studies that support the use of Metformin in pregnancy - but she is as head strong as I am and her stance is insulin has been around for 60 years whereas Metformin is only very new still.

[azaria30]

I'm in the same boat. Warren Kidson advised me to continue with metformin. I have a healthy 4 year old daughter and I was on metformin for the entirety of my preg with her.

The obs is concerned about me continuing with metformin as well and I'm 26 weeks preg. I would agree that her concerns seem to be based on metformin being an "unknown" drug as opposed to insulin.

I read a study that said 76% of women with PCOS would chose metformin as a treatment during preg again, and 27% of women who had PCOS and took insulin would go ahead with insulin in any subsequent pregnancies.

All the research I've done myself suggests that metformin has a positive effect on preg women with PCOS, reduced miscarriage rate, reduced rate of GB, and reduced rate of overweight (large) babies at birth.

The Diabetes Australia website states "Metformin safe in pregnancy but more research required". They are not going to say that if they have serious doubts about it's safety.

Feel free to email me and all the best with the end of your preg.