MATERNAL KNOWLEDGE AND MEDICATION ADHERENCE AMONG WOMEN WITH GESTATIONAL DIABETES MELLITUS RECEIVING METFORMIN THERAPY AND ITS ASSOCIATION WITH GLYCEMIC CONTROL

Abstract

Background: Gestational Diabetes Mellitus (GDM) is a common metabolic complication of pregnancy with increasing global prevalence. Metformin has emerged as an effective oral alternative to insulin for GDM management. However, treatment success depends not only on drug efficacy but also on maternal knowledge and medication adherence. This study aimed to assess maternal knowledge and medication adherence among women with GDM receiving Metformin therapy and examine their association with glycemic control.

Methods: This prospective observational study was conducted from January 2025 to September 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 sociodemographic characteristics, maternal knowledge regarding GDM and Metformin, and medication adherence using a standardized scale. Glycemic control was assessed based on fasting blood glucose <95 mg/dL and postprandial glucose <140 mg/dL. Statistical analysis was performed using statistical package for social sciences (SPSS) version 16, with a p-value <0.05 considered significant.

Results: The age of participants was between 31–35 years in 37.0% (n=20), with 59.3% (n=32) being multigravida. The majority (70.4%, n=38) presented at or beyond 28 weeks of gestation. Regarding knowledge, 27.8% (n=15) had good knowledge, 44.4% (n=24) had moderate knowledge, and 27.8% (n=15) had poor knowledge about GDM and Metformin therapy. Medication adherence was high in 37.0% (n=20), moderate in 40.7% (n=22), and low in 22.2% (n=12) of participants. Glycemic control was achieved in 61.1% (n=33) of women, while 38.9% (n=21) remained uncontrolled. A statistically significant association was found between maternal knowledge and glycemic control (p=0.01), with 86.7% (n=13) of women with good knowledge achieving controlled glycemia compared to 33.3% (n=5) with poor knowledge. Similarly, medication adherence showed a strong significant association with glycemic control (p=0.001), with 85.0% (n=17) of highly adherent women achieving control versus 33.3% (n=4) with low adherence.

Conclusion: Maternal knowledge and medication adherence are significant determinants of glycemic control in women with GDM receiving Metformin. The substantial proportion of women with poor knowledge and low adherence highlights the need for targeted educational interventions and adherence support strategies to optimize pregnancy outcomes