diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13161diaendo-13161Research ArticleНовостиNewsМесто метформина в лечении нарушений углеводного обмена и инсулинорезистентности при планировании беременности, после ее наступления и родоразрешения: резолюция совета экспертовThe place of metformin in the treatment of carbohydrate metabolism disorders and insulin resistance during, before and after pregnancy: resolution of the expert councilhttps://orcid.org/0000-0002-5057-127XШестаковаМ. В.ShestakovaM. V.

Шестакова Марина Владимировна, д.м.н., профессор, академик РАН 

117036, Москва, ул. Дм. Ульянова, д. 11 

Marina V. Shestakova, MD, PhD, Professor

11 Dm. Ulyanova str., Moscow, 117036 

nephro@endocrincentr.ruhttps://orcid.org/0000-0002-5634-7877МельниченкоГ. А.MelnichenkoG. A.

Мельниченко Галина Афанасьевна, д.м.н., профессор, академик РАН 

Москва

Galina A. Melnichenko, MD, PhD, Professor

Moscow

teofrast2000@mail.ruhttps://orcid.org/0000-0001-8425-0020АндрееваЕ. Н.AndreevaE. N.

Андреева Елена Николаевна, д.м.н., профессор 

Москва

Elena N. Andreeva, MD, PhD, Professor

Moscow

iceberg1995@mail.ruhttps://orcid.org/0000-0002-3443-7206СухареваО. Ю.SukharevaO. Y.

Сухарева Ольга Юрьевна, к.м.н., в.н.с. 

Москва

Olga Y. Sukhareva, MD, PhD, leading researcher

Moscow

olgasukhareva@mail.ruhttps://orcid.org/0000-0001-7470-1676ВоротниковаС. Ю.VorotnikovaS. Y.

Воротникова Светлана Юрьевна, к.м.н. 

Москва

Svetlana Y. Vorotnikova, MD

Moscow

bra_svetix@list.ruhttps://orcid.org/0000-0003-3535-520XИбрагимоваЛ. И.IbragimovaL. I.

Ибрагимова Людмила Ибрагимовна, к.м.н., в.н.с. 

Москва

Liudmila I. Ibragimova, MD, PhD, leading research associate

Moscow

ibragimovaliudmila@gmail.comhttps://orcid.org/0000-0001-9943-0964БурумкуловаФ. Ф.BurumkulovaF. F.

Бурумкулова Фатима Фархадовна, д.м.н., в.н.с. 

Москва

Fatima F. Burumkulova, MD, PhD, leading research associate

Moscow

fatima-burumkulova@yandex.ruДемидоваТ. Ю.DemidovaT. Y.

Демидова Татьяна Юльевна, д.м.н., профессор 

Researcher ID: D-3425-2018;

Author ID: 7003771623

Москва

Tatiana Y. Demidova, MD, PhD, Professor

Researcher ID: D-3425-2018;

Author ID: 7003771623

Moscow

t.y.demidova@gmail.comhttps://orcid.org/0000-0001-8955-5085ДерябинаЕ. Г.DeryabinaE. G.

Дерябина Елена Геннадьевна, д.м.н., в.н.с.

Екатеринбург

Elena G. Deryabina, MD, PhD, leading research associate

Ekaterinburg

helen_mic@mail.ruhttps://orcid.org/0000-0002-2512-833XТиселькоА. В.TiselkoA. V.

Тиселько Алена Викторовна, д.м.н.

Санкт-Петербург

Alena V. Tiselko, MD, PhD

Saint Petersburg

alenadoc@mail.ruhttps://orcid.org/0000-0002-1948-8523ЧулковВ. С.ChulkovV. S.

Чулков Василий Сергеевич, д.м.н., доцент

Великий Новгород

Vasiliy S. Chulkov, MD, PhD, Associate Professor

Veliky Novgorod

vschulkov@rambler.ruГНЦ РФ ФГБУ «Национальный медицинский исследовательский центр эндокринологии»РоссияEndocrinology Research CentreRussian FederationМосковский областной научно-исследовательский институт акушерства и гинекологии имени академика В.И. КраснопольскогоРоссияMoscow Regional Research Institute of Obstetrics and GynecologyRussian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian FederationУральский научно-исследовательский институт охраны материнства и младенчестваРоссияUrals Scientific Research Institute for Maternal and Child CareRussian FederationНаучно-исследовательский институт акушерства, гинекологии и репродуктологии имени Д.О. ОттаРоссияThe Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. OttRussian FederationНовгородский государственный университет имени Ярослава МудрогоРоссияYaroslav-the-Wise Novgorod State UniversityRussian Federation202425062024273302313Copyright © Шестакова М.В., Мельниченко Г.А., Андреева Е.Н., Сухарева О.Ю., Воротникова С.Ю., Ибрагимова Л.И., Бурумкулова Ф.Ф., Демидова Т.Ю., Дерябина Е.Г., Тиселько А.В., Чулков В.С., 20242024Шестакова М.В., Мельниченко Г.А., Андреева Е.Н., Сухарева О.Ю., Воротникова С.Ю., Ибрагимова Л.И., Бурумкулова Ф.Ф., Демидова Т.Ю., Дерябина Е.Г., Тиселько А.В., Чулков В.С.Shestakova M.V., Melnichenko G.A., Andreeva E.N., Sukhareva O.Y., Vorotnikova S.Y., Ibragimova L.I., Burumkulova F.F., Demidova T.Y., Deryabina E.G., Tiselko A.V., Chulkov V.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13161

Благодаря влиянию на инсулинорезистентность, удобству приема и благоприятному профилю безопасности метформин был включен в рекомендации зарубежных медицинских сообществ по ведению беременных с гипергликемией начиная с 2008 г. Однако в Российской Федерации до настоящего времени назначение любых пероральных сахароснижающих средств во время беременности противопоказано. Тем не менее последние исследования демонстрируют безопасность и положительное влияние метформина на течение беременности у пациенток с прегестационным сахарным диабетом, синдромом поликистозных яичников и гестационным сахарным диабетом. В 2023 г. Федеральной службой по надзору в сфере здравоохранения Минздрава России были обновлены инструкции по медицинскому применению препаратов Глюкофаж® и Глюкофаж®Лонг: беременность была исключена из раздела «Противопоказания» и перенесена в раздел «С осторожностью». Данная резолюция призвана призван оценить исследования эффективности и безопасности метформина, а также изучить опыт зарубежных коллег и российские юридические аспекты назначения метформина на этапах подготовки к беременности, во время беременности и в послеродовом периоде.

Due to its effect on insulin resistance, ease of administration and favorable safety profile, metformin has been included in the recommendations of foreign medical communities for the management of pregnant women with hyperglycemia since 2008. However, in Russia, the use of any oral hypoglycemic agents during pregnancy is still contraindicated. However, recent studies demonstrate the safety and positive effects of metformin on pregnancy in patients with pregestational diabetes mellitus, polycystic ovary syndrome and gestational diabetes mellitus. In 2023, the Federal Service for Surveillance in Healthcare of the Ministry of Health of Russia updated the instructions for the medical use of Glucophage® and Glucophage®Long: pregnancy was excluded from the “Contraindications” section and moved to the “With caution” section. This resolution is intended to evaluate studies of the effectiveness and safety of metformin, as well as to study the experience of foreign colleagues and Russian legal aspects of prescribing metformin in the stages of preparation for pregnancy, during it and in the post-gravid period.

метформинбеременностьлактациягрудное вскармливаниесахарный диабет 2 типагестационный сахарный диабетпредиабетсиндром поликистозных яичниковmetforminpregnancylactationbreastfeedingtype 2 diabetes mellitusgestational diabetes mellitusprediabetespolycystic ovary syndromeСовет экспертов, результаты которого легли в основу этой статьи, проводился при поддержке ООО «Мерк»ReferencesGestational diabetes. International Diabetes Federation. [Accessed: 2023 Nov 27]Gestational diabetes. International Diabetes Federation. [Accessed: 2023 Nov 27]McIntyre HD, Fuglsang J, Kampmann U, Knorr S, Ovesen P. Hyperglycemia in Pregnancy and Women’s Health in the 21st Century. Int J Environ Res Public Health. 2022;19(24):16827. doi: https://doi.org/10.3390/ijerph192416827McIntyre HD, Fuglsang J, Kampmann U, Knorr S, Ovesen P. Hyperglycemia in Pregnancy and Women’s Health in the 21st Century. Int J Environ Res Public Health. 2022;19(24):16827. doi: https://doi.org/10.3390/ijerph192416827Управление Федеральной службы государственной статистики по Свердловской области и Курганской области — Население [Электронный ресурс]. URL: https://66.rosstat.gov.ru/folder/29698 (дата обращения: 27.11.2023)Office of the Federal State Statistics Service for the Sverdlovsk Region and Kurgan Region - Population [Internet](In Russ.)Malaza N, Masete M, Adam S, et al. A Systematic Review to Compare Adverse Pregnancy Outcomes in Women with Pregestational Diabetes and Gestational Diabetes. Int J Environ Res Public Health. 2022;19(17):10846. doi: https://doi.org/10.3390/ijerph191710846Malaza N, Masete M, Adam S, et al. A Systematic Review to Compare Adverse Pregnancy Outcomes in Women with Pregestational Diabetes and Gestational Diabetes. Int J Environ Res Public Health. 2022;19(17):10846. doi: https://doi.org/10.3390/ijerph191710846Freinkel N. Banting Lecture 1980: of Pregnancy and Progeny. Diabetes. 1980;29(12):1023–35. doi: https://doi.org/10.2337/diab.29.12.1023Freinkel N. Banting Lecture 1980: of Pregnancy and Progeny. Diabetes. 1980;29(12):1023–35. doi: https://doi.org/10.2337/diab.29.12.1023Hart BN, Shubrook JH, Mason T. Pregestational Diabetes and Family Planning. Clin Diabetes. 2021;39(3):323–8. doi: https://doi.org/10.2337/cd20-0062Hart BN, Shubrook JH, Mason T. Pregestational Diabetes and Family Planning. Clin Diabetes. 2021;39(3):323–8. doi: https://doi.org/10.2337/cd20-0062Hughes RCE, Moore MP, Gullam JE, et al. An early pregnancy HbA1c ≥5.9% (41 mmol/mol) is optimal for detecting diabetes and identifies women at increased risk of adverse pregnancy outcomes. Diabetes Care. 2014;37(11):2953–9. doi: https://doi.org/10.2337/dc14-1312Hughes RCE, Moore MP, Gullam JE, et al. An early pregnancy HbA1c ≥5.9% (41 mmol/mol) is optimal for detecting diabetes and identifies women at increased risk of adverse pregnancy outcomes. Diabetes Care. 2014;37(11):2953–9. doi: https://doi.org/10.2337/dc14-1312Mañé L, Flores-Le Roux JA, Benaiges D, et al. Role of First-Trimester HbA1c as a Predictor of Adverse Obstetric Outcomes in a Multiethnic Cohort. J Clin Endocrinol Metab. 2017;102(2):390–7. doi: https://doi.org/10.1210/jc.2016-2581Mañé L, Flores-Le Roux JA, Benaiges D, et al. Role of First-Trimester HbA1c as a Predictor of Adverse Obstetric Outcomes in a Multiethnic Cohort. J Clin Endocrinol Metab. 2017;102(2):390–7. doi: https://doi.org/10.1210/jc.2016-2581Schiller T, Barak O, Winter Shafran Y, et al. Prediabetes in pregnancy – follow-up, treatment, and outcomes compared to overt pregestational diabetes. The Journal of Maternal-Fetal & Neonatal Medicine. 2023;36(1):2191153. doi: https://doi.org/10.1080/14767058.2023.2191153Schiller T, Barak O, Winter Shafran Y, et al. Prediabetes in pregnancy – follow-up, treatment, and outcomes compared to overt pregestational diabetes. The Journal of Maternal-Fetal & Neonatal Medicine. 2023;36(1):2191153. doi: https://doi.org/10.1080/14767058.2023.2191153Российская ассоциация эндокринологов. Клинические рекомендации «Сахарный диабет 2 типа у взрослых» // 2022Russian Association of Endocrinologists. Clinical guidelines “Type 2 diabetes mellitus in adults.” 2022 (In Russ.)Allen AJ, Snowden JM, Lau B, et al. Type-2 diabetes mellitus: does prenatal care affect outcomes? J Matern Fetal Neonatal Med. 2018;31(1):93–7. doi: https://doi.org/10.1080/14767058.2016.1276558Allen AJ, Snowden JM, Lau B, et al. Type-2 diabetes mellitus: does prenatal care affect outcomes? J Matern Fetal Neonatal Med. 2018;31(1):93–7. doi: https://doi.org/10.1080/14767058.2016.1276558Yamamoto JM, Hughes DJF, Evans ML, et al. Communitybased pre-pregnancy care programme improves pregnancy preparation in women with pregestational diabetes. Diabetologia. 2018;61(7):1528–37. doi: https://doi.org/10.1007/s00125-018-4613-3Yamamoto JM, Hughes DJF, Evans ML, et al. Communitybased pre-pregnancy care programme improves pregnancy preparation in women with pregestational diabetes. Diabetologia. 2018;61(7):1528–37. doi: https://doi.org/10.1007/s00125-018-4613-3Sharpe A, Morley LC, Tang T, et al. Metformin for ovulation induction (excluding gonadotrophins) in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2019;2019(12):CD013505. doi: https://doi.org/10.1002/14651858.CD013505Sharpe A, Morley LC, Tang T, et al. Metformin for ovulation induction (excluding gonadotrophins) in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2019;2019(12):CD013505. doi: https://doi.org/10.1002/14651858.CD013505Teede HJ, Tay CT, Laven JJE, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Eur J Endocrinol. 2023;189(2):G43–64. doi: https://doi.org/10.1093/ejendo/lvad096Teede HJ, Tay CT, Laven JJE, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Eur J Endocrinol. 2023;189(2):G43–64. doi: https://doi.org/10.1093/ejendo/lvad096Sonagra AD, Biradar SM, K. D, et al. Normal Pregnancy- A State of Insulin Resistance. J Clin Diagn Res. 2014;8(11):CC01–3. doi: https://doi.org/10.7860/JCDR/2014/10068.5081Sonagra AD, Biradar SM, K. D, et al. Normal Pregnancy- A State of Insulin Resistance. J Clin Diagn Res. 2014;8(11):CC01–3. doi: https://doi.org/10.7860/JCDR/2014/10068.5081Kampmann U, Knorr S, Fuglsang J, et al. Determinants of Maternal Insulin Resistance during Pregnancy: An Updated Overview. J Diabetes Res. 2019;2019:5320156. doi: https://doi.org/10.1155/2019/5320156Kampmann U, Knorr S, Fuglsang J, et al. Determinants of Maternal Insulin Resistance during Pregnancy: An Updated Overview. J Diabetes Res. 2019;2019:5320156. doi: https://doi.org/10.1155/2019/5320156Yeh T, Yeung M, Mendelsohn Curanaj FA. Inpatient Glycemic Management of the Pregnant Patient. Curr Diab Rep. 2018;18(10):73. doi: https://doi.org/10.1007/s11892-018-1045-xYeh T, Yeung M, Mendelsohn Curanaj FA. Inpatient Glycemic Management of the Pregnant Patient. Curr Diab Rep. 2018;18(10):73. doi: https://doi.org/10.1007/s11892-018-1045-xLawal SK, Adeniji AA, Sulaiman SO, et al. Comparative effects of glibenclamide, metformin and insulin on fetal pancreatic histology and maternal blood glucose in pregnant streptozotocininduced diabetic rats. Afr Health Sci. 2019;19(3):2491–504. doi: https://doi.org/10.4314/ahs.v19i3.25Lawal SK, Adeniji AA, Sulaiman SO, et al. Comparative effects of glibenclamide, metformin and insulin on fetal pancreatic histology and maternal blood glucose in pregnant streptozotocininduced diabetic rats. Afr Health Sci. 2019;19(3):2491–504. doi: https://doi.org/10.4314/ahs.v19i3.25Nguyen L, Chan S-Y, Teo AKK. Metformin from mother to unborn child – Are there unwarranted effects? EBioMedicine. 2018;35:394–404. doi: https://doi.org/10.1016/j.ebiom.2018.08.047Nguyen L, Chan S-Y, Teo AKK. Metformin from mother to unborn child – Are there unwarranted effects? EBioMedicine. 2018;35:394–404. doi: https://doi.org/10.1016/j.ebiom.2018.08.047Pollex EK, Feig DS, Lubetsky A, et al. Insulin Glargine Safety in Pregnancy. Diabetes Care. 2010;33(1):29–33. doi: https://doi.org/10.2337/dc09-1045Pollex EK, Feig DS, Lubetsky A, et al. Insulin Glargine Safety in Pregnancy. Diabetes Care. 2010;33(1):29–33. doi: https://doi.org/10.2337/dc09-1045Menon RK, Cohen RM, Sperling MA, et al. Transplacental passage of insulin in pregnant women with insulindependent diabetes mellitus. Its role in fetal macrosomia. N Engl J Med. 1990;323(5):309–15. doi: https://doi.org/10.1056/NEJM199008023230505Menon RK, Cohen RM, Sperling MA, et al. Transplacental passage of insulin in pregnant women with insulindependent diabetes mellitus. Its role in fetal macrosomia. N Engl J Med. 1990;323(5):309–15. doi: https://doi.org/10.1056/NEJM199008023230505Vanky E, Stridsklev S, Heimstad R, et al. Metformin versus placebo from first trimester to delivery in polycystic ovary syndrome: a randomized, controlled multicenter study. J Clin Endocrinol Metab. 2010;95(12):E448-455. doi: https://doi.org/10.1210/jc.2010-0853Vanky E, Stridsklev S, Heimstad R, et al. Metformin versus placebo from first trimester to delivery in polycystic ovary syndrome: a randomized, controlled multicenter study. J Clin Endocrinol Metab. 2010;95(12):E448-455. doi: https://doi.org/10.1210/jc.2010-0853Feig DS, Donovan LE, Zinman B, et al. Metformin in women with type 2 diabetes in pregnancy (MiTy): a multicentre, international, randomised, placebo-controlled trial. The Lancet Diabetes & Endocrinology. 2020;8(10):834–44. doi: https://doi.org/10.1016/S2213-8587(20)30310-7Feig DS, Donovan LE, Zinman B, et al. Metformin in women with type 2 diabetes in pregnancy (MiTy): a multicentre, international, randomised, placebo-controlled trial. The Lancet Diabetes & Endocrinology. 2020;8(10):834–44. doi: https://doi.org/10.1016/S2213-8587(20)30310-7Feig DS, Sanchez JJ, Murphy KE, et al. Outcomes in children of women with type 2 diabetes exposed to metformin versus placebo during pregnancy (MiTy Kids): a 24-month follow-up of the MiTy randomised controlled trial. Lancet Diabetes Endocrinol. 2023;11(3):191–202. doi: https://doi.org/10.1016/S2213-8587(23)00004-9Feig DS, Sanchez JJ, Murphy KE, et al. Outcomes in children of women with type 2 diabetes exposed to metformin versus placebo during pregnancy (MiTy Kids): a 24-month follow-up of the MiTy randomised controlled trial. Lancet Diabetes Endocrinol. 2023;11(3):191–202. doi: https://doi.org/10.1016/S2213-8587(23)00004-9Rowan JA, Hague WM, Gao W, et al. Metformin versus Insulin for the Treatment of Gestational Diabetes. New England Journal of Medicine. 2008;358(19):2003–15. doi: https://doi.org/10.1056/NEJMoa0707193Rowan JA, Hague WM, Gao W, et al. Metformin versus Insulin for the Treatment of Gestational Diabetes. New England Journal of Medicine. 2008;358(19):2003–15. doi: https://doi.org/10.1056/NEJMoa0707193Rowan JA, Rush EC, Plank LD, et al. Metformin in gestational diabetes: the offspring follow-up (MiG TOFU): body composition and metabolic outcomes at 7–9 years of age. BMJ Open Diabetes Res Care. 2018;6(1):e000456. doi: https://doi.org/10.1136/bmjdrc-2017-000456Rowan JA, Rush EC, Plank LD, et al. Metformin in gestational diabetes: the offspring follow-up (MiG TOFU): body composition and metabolic outcomes at 7–9 years of age. BMJ Open Diabetes Res Care. 2018;6(1):e000456. doi: https://doi.org/10.1136/bmjdrc-2017-000456Clausen TD, Mathiesen E, Ekbom P, et al. Poor pregnancy outcome in women with type 2 diabetes. Diabetes Care. 2005;28(2):323–8. doi: https://doi.org/10.2337/diacare.28.2.323Clausen TD, Mathiesen E, Ekbom P, et al. Poor pregnancy outcome in women with type 2 diabetes. Diabetes Care. 2005;28(2):323–8. doi: https://doi.org/10.2337/diacare.28.2.323Verheijen ECJ, Critchley JA, Whitelaw DC, et al. Outcomes of pregnancies in women with pre-existing type 1 or type 2 diabetes, in an ethnically mixed population. BJOG. 2005;112(11):1500–3. doi: https://doi.org/10.1111/j.1471-0528.2005.00747.xVerheijen ECJ, Critchley JA, Whitelaw DC, et al. Outcomes of pregnancies in women with pre-existing type 1 or type 2 diabetes, in an ethnically mixed population. BJOG. 2005;112(11):1500–3. doi: https://doi.org/10.1111/j.1471-0528.2005.00747.xAsbjörnsdóttir B, Rasmussen SS, Kelstrup L, et al. Impact of restricted maternal weight gain on fetal growth and perinatal morbidity in obese women with type 2 diabetes. Diabetes Care. 2013;36(5):1102–6. doi: https://doi.org/10.2337/dc12-1232Asbjörnsdóttir B, Rasmussen SS, Kelstrup L, et al. Impact of restricted maternal weight gain on fetal growth and perinatal morbidity in obese women with type 2 diabetes. Diabetes Care. 2013;36(5):1102–6. doi: https://doi.org/10.2337/dc12-1232Sato T, Sugiyama T, Kurakata M, et al. Pregnancy outcomes in women with type 1 and type 2 diabetes mellitus in a retrospective multi-institutional study in Japan. Endocr J. 2014;61(8):759–64. doi: https://doi.org/10.1507/endocrj.ej14-0140Sato T, Sugiyama T, Kurakata M, et al. Pregnancy outcomes in women with type 1 and type 2 diabetes mellitus in a retrospective multi-institutional study in Japan. Endocr J. 2014;61(8):759–64. doi: https://doi.org/10.1507/endocrj.ej14-0140Гурьева В.М. и др. Осложнения беременности и перинатальные исходы у женщин с сахарным диабетом 2-го типа // Российский вестник акушера-гинеколога. — 2013. — Т. 13. — №1. — С. 37–41.Gur’eva VM, et al. Pregnancy complications and perinatal outcomes in women with type 2 diabetes mellitus. Russian Bulletin of Obstetrician-Gynecologist. 2013;13(1):37-41. (In Russ.).Hyperglycemia and Adverse Pregnancy Outcomes. New England Journal of Medicine. 2008;358(19):1991–2002. doi: https://doi.org/10.1056/NEJMoa0707943Hyperglycemia and Adverse Pregnancy Outcomes. New England Journal of Medicine. 2008;358(19):1991–2002. doi: https://doi.org/10.1056/NEJMoa0707943Алгоритмы специализированной медицинской помощи больным сахарным диабетом / Под ред. И.И. Дедова, М.В. Шестаковой, А.Ю. Майорова. — 11-й вып. — М.; 2023. doi: https://doi.org/10.14341/DM13042Dedov II, Shestakova MV, Mayorov AYu, et al. Standards of specialized diabetes care. 11th edition. Moscow, 2023 (In Russ.)] doi: https://doi.org/10.14341/DM13042Российская ассоциация эндокринологов, Российское общество акушеров-гинекологов. Российский национальный консенсус «Гестационный сахарный диабет: диагностика, лечение, послеродовое наблюдение». — 2013 Available from: https://rae-org.ru/system/files/documents/pdf/rek_gest_dm_2013.pdfRussian Association of Endocrinologists, Russian Society of Obstetricians and Gynecologists. Russian national consensus «Gestational diabetes mellitus: diagnosis, treatment, postpartum care». 2013 [cited 2023 Nov 27]; Available from: https://rae-org.ru/system/files/documents/pdf/rek_gest_dm_2013.pdf (in Russ.)Balsells M, García-Patterson A, Solà I, et al. Glibenclamide, metformin, and insulin for the treatment of gestational diabetes: a systematic review and meta-analysis. BMJ. 2015;350:h102. doi: https://doi.org/10.1136/bmj.h102Balsells M, García-Patterson A, Solà I, et al. Glibenclamide, metformin, and insulin for the treatment of gestational diabetes: a systematic review and meta-analysis. BMJ. 2015;350:h102. doi: https://doi.org/10.1136/bmj.h102Hanem LGE, Salvesen Ø, Juliusson PB, et al. Intrauterine metformin exposure and offspring cardiometabolic risk factors (PedMet study): a 5-10 year follow-up of the PregMet randomised controlled trial. Lancet Child Adolesc Health. 2019;3(3):166–74. doi: https://doi.org/10.1016/S2352-4642(18)30385-7Hanem LGE, Salvesen Ø, Juliusson PB, et al. Intrauterine metformin exposure and offspring cardiometabolic risk factors (PedMet study): a 5-10 year follow-up of the PregMet randomised controlled trial. Lancet Child Adolesc Health. 2019;3(3):166–74. doi: https://doi.org/10.1016/S2352-4642(18)30385-7Tartarin P, Moison D, Guibert E, et al. Metformin exposure affects human and mouse fetal testicular cells. Human Reproduction. 2012;27(11):3304–14. doi: https://doi.org/10.1093/humrep/des264Tartarin P, Moison D, Guibert E, et al. Metformin exposure affects human and mouse fetal testicular cells. Human Reproduction. 2012;27(11):3304–14. doi: https://doi.org/10.1093/humrep/des264American Diabetes Association Professional Practice Committee. 15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2024. Diabetes Care. 2023;47(Supplement_1):S282–94. doi: https://doi.org/10.2337/dc24-S015American Diabetes Association Professional Practice Committee. 15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2024. Diabetes Care. 2023;47(Supplement_1):S282–94. doi: https://doi.org/10.2337/dc24-S015NICE. Diabetes in pregnancy: management from preconception to the postnatal period [Internet]. NICE; 2020 [Accessed: 2023 Nov 27]NICE. Diabetes in pregnancy: management from preconception to the postnatal period [Internet]. NICE; 2020 [Accessed: 2023 Nov 27]SMFM Statement: Pharmacological treatment of gestational diabetes. American Journal of Obstetrics & Gynecology. 2018;218(5):B2–4. doi: https://doi.org/10.1016/j.ajog.2018.01.041SMFM Statement: Pharmacological treatment of gestational diabetes. American Journal of Obstetrics & Gynecology. 2018;218(5):B2–4. doi: https://doi.org/10.1016/j.ajog.2018.01.041American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 201: Pregestational Diabetes Mellitus. Obstet Gynecol. 2018;132(6):e228–48. doi: https://doi.org/10.1097/AOG.0000000000002960American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 201: Pregestational Diabetes Mellitus. Obstet Gynecol. 2018;132(6):e228–48. doi: https://doi.org/10.1097/AOG.0000000000002960ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstetrics & Gynecology. 2018;131(2):e49. doi: https://doi.org/10.1097/AOG.0000000000002501ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstetrics & Gynecology. 2018;131(2):e49. doi: https://doi.org/10.1097/AOG.0000000000002501Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes. 2018;42(Suppl 1):S1–325Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes. 2018;42(Suppl 1):S1–325Blumer I, Hadar E, Hadden DR, et al. Diabetes and Pregnancy: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism. 2013;98(11):4227–49. doi: https://doi.org/10.1210/jc.2013-2465Blumer I, Hadar E, Hadden DR, et al. Diabetes and Pregnancy: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism. 2013;98(11):4227–49. doi: https://doi.org/10.1210/jc.2013-2465Queensland Clinical Guidelines. Maternity and Neonatal Clinical Guideline. Gestational diabetes mellitus (GDM). 2021; Available at: https://www.health.qld.gov.au/__data/assets/pdf_file/0022/950503/g-gdm.pdfQueensland Clinical Guidelines. Maternity and Neonatal Clinical Guideline. Gestational diabetes mellitus (GDM). 2021; Available at: https://www.health.qld.gov.au/__data/assets/pdf_file/0022/950503/g-gdm.pdfRudland VL, Price SAL, Hughes R, et al. ADIPS 2020 guideline for pre-existing diabetes and pregnancy. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2020;60(6):E18–52. doi: https://doi.org/10.1111/ajo.13265Rudland VL, Price SAL, Hughes R, et al. ADIPS 2020 guideline for pre-existing diabetes and pregnancy. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2020;60(6):E18–52. doi: https://doi.org/10.1111/ajo.13265Daly B, Toulis KA, Thomas N, et al. Increased risk of ischemic heart disease, hypertension, and type 2 diabetes in women with previous gestational diabetes mellitus, a target group in general practice for preventive interventions: A population-based cohort study. PLoS Med. 2018;15(1):e1002488. doi: https://doi.org/10.1371/journal.pmed.1002488Daly B, Toulis KA, Thomas N, et al. Increased risk of ischemic heart disease, hypertension, and type 2 diabetes in women with previous gestational diabetes mellitus, a target group in general practice for preventive interventions: A population-based cohort study. PLoS Med. 2018;15(1):e1002488. doi: https://doi.org/10.1371/journal.pmed.1002488Li Z, Cheng Y, Wang D, et al. Incidence Rate of Type 2 Diabetes Mellitus after Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of 170,139 Women. J Diabetes Res. 2020;2020:3076463. doi: https://doi.org/10.1155/2020/3076463Li Z, Cheng Y, Wang D, et al. Incidence Rate of Type 2 Diabetes Mellitus after Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of 170,139 Women. J Diabetes Res. 2020;2020:3076463. doi: https://doi.org/10.1155/2020/3076463Elbeltagi R, Al-Beltagi M, Saeed NK, et al. Cardiometabolic effects of breastfeeding on infants of diabetic mothers. World J Diabetes. 2023;14(5):617–31. doi: https://doi.org/10.4239/wjd.v14.i5.617Elbeltagi R, Al-Beltagi M, Saeed NK, et al. Cardiometabolic effects of breastfeeding on infants of diabetic mothers. World J Diabetes. 2023;14(5):617–31. doi: https://doi.org/10.4239/wjd.v14.i5.617Gunderson EP. Breast-Feeding and Diabetes: Long-Term Impact on Mothers and Their Infants. Curr Diab Rep. 2008;8(4):279–86Gunderson EP. Breast-Feeding and Diabetes: Long-Term Impact on Mothers and Their Infants. Curr Diab Rep. 2008;8(4):279–86Wu P, Park K, Gulati M. The Fourth Trimester: Pregnancy as a Predictor of Cardiovascular Disease. Eur Cardiol. 2021;16:e31. doi: https://doi.org/10.15420/ecr.2021.18Wu P, Park K, Gulati M. The Fourth Trimester: Pregnancy as a Predictor of Cardiovascular Disease. Eur Cardiol. 2021;16:e31. doi: https://doi.org/10.15420/ecr.2021.18Инструкция по применению лекарственного препарата “Глюкофаж” П N014600/01“Glucophage” Drug Label №P N014600/01 (in Russ.)Инструкция по медицинскому применению Глюкофаж® Лонг 500 мг ЛСР-002098/10; Инструкция по медицинскому применению Глюкофаж® Лонг 750 мг ЛП-000509; Инструкция по медицинскому применению Глюкофаж® Лонг 1000 мг ЛП-002396Glucophage® Long 500 mg Drug Label №LSR-002098/10; Glucophage® Long 750 mg Drug Label №LP-000509; Glucophage® Long 1000 mg Drug Label №LP-002396 (in Russ.)

The authors declare that there are no conflicts of interest present.