KNOWLEDGE, PERCEPTIONS, AND PSYCHOSOCIAL CONCERNS REGARDING METFORMIN THERAPY AMONG WOMEN WITH GESTATIONAL DIABETES MELLITUS

Abstract

Background: Gestational Diabetes Mellitus (GDM) is a prevalent pregnancy complication with rising global incidence. Metformin is increasingly used as an oral therapeutic alternative to insulin; however, maternal perceptions and psychosocial concerns regarding its use remain underexplored, particularly in low-resource settings. 

Aim: This study aimed to assess knowledge, perceptions, and psychosocial concerns regarding Metformin therapy among women with GDM.

Methods: This prospective observational study was conducted from January 2025 to May 2025 at Fatima Hospital, Baqai Medical University, Karachi. A total of 54 pregnant women with a confirmed diagnosis of GDM receiving Metformin therapy were enrolled using consecutive sampling. Data were collected using a structured, pretested, interviewer-administered questionnaire covering maternal knowledge, perceptions regarding Metformin safety and acceptance, and psychosocial concerns including anxiety, fear of fetal harm, emotional distress, and need for counselling support. Statistical analysis was performed using statistical package for social sciences (SPSS) version 16, with a p-value <0.05 considered significant.

Results: The mean age of participants was 31.4 ± 4.8 years, with 57.4% (n=31) being multigravida and 72.2% (n=39) in the third trimester. Knowledge assessment revealed moderate knowledge in 46.3% (n=25), poor knowledge in 29.6% (n=16), and good knowledge in 24.1% (n=13). Perceived safety of Metformin was reported as confident by 51.9% (n=28), uncertain by 33.3% (n=18), and negative by 14.8% (n=8). Treatment acceptance was positive in 59.3% (n=32), neutral in 25.9% (n=14), and reluctant in 14.8% (n=8). High anxiety regarding pregnancy outcomes was reported by 35.2% (n=19), fear of fetal harm by 38.9% (n=21), and significant emotional distress by 31.5% (n=17). A strong need for counselling support was expressed by 63.0% (n=34). A statistically significant association was found between knowledge level and psychosocial burden (p=0.02), with poor knowledge linked to higher psychological distress.

Conclusion: Women with GDM receiving Metformin demonstrate moderate knowledge, uncertain perceptions regarding medication safety, and considerable psychosocial burden. Poor knowledge is significantly associated with greater psychological distress. Structured, patient-centered counselling addressing both clinical and emotional aspects of GDM care is essential to improve treatment acceptance, psychological well-being, and overall pregnancy outcomes.