What does this research mean for the field?

Combined therapy with insulin glargine and metformin provides superior protection against diabetes-induced embryopathy and fetal malformations compared to either monotherapy. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To characterize streptozotocin-induced diabetic embryopathy and evaluate the comparative efficacy of insulin glargine, metformin, and their combination against maternal diabetes-induced teratogenicity.

September 14, 2026Journal of Obstetrics Gynecology and Cancer ResearchOpen Access

Embryotoxicity and Teratogenicity of Streptozotocin-Induced Insulin-Deficient Maternal Diabetes in Sprague-Dawley Rats: A Comparative Evaluation of Insulin Glargine, Metformin, and Combined Therapy

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Authors

NSNoor Noori Abid Al ShammaryMiddle Technical University RSRasha Noori Abid Al ShammaryUniversity of Wasit

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Implication

Randomized controlled animal study demonstrates reduced fetal malformations with combined insulin-metformin therapy in diabetic rats, suggesting complementary protective mechanisms.

Key Points

To characterize streptozotocin-induced diabetic embryopathy and evaluate the comparative efficacy of insulin glargine, metformin, and their combination against maternal diabetes-induced teratogenicity.
Forty-eight time-mated Sprague-Dawley dams were allocated by blinded block randomization into six groups (n=8 litters per group): normal control, citrate-buffer control, untreated diabetic, and diabetic treated with insulin glargine (2 IU/kg/day s.c.), metformin (200 mg/kg/day p.o.), or their combination.
Diabetes was induced using streptozotocin (50 mg/kg i.p.) on gestational day 7, with daily treatments administered from gestational day 8 to 20, followed by fetal harvest on gestational days 20–21 alongside a gestational day 12–18 satellite cohort.
Untreated diabetic dams developed marked hyperglycemia (389.2±22.6 mg/dL at GD 20) with a fetal malformation prevalence of 44.3% (95% CI 38.1–50.7), a fourfold increase in placental malondialdehyde, a 4.82-fold increase in cleaved Caspase-3, and reductions of Pax3 and Sox2 expression to 31% and 28% of control levels.
Combined therapy significantly lowered malformation prevalence to 4.7% (95% CI 2.4–8.6), returned fetal weight to 91.2% of control, and surpassed insulin monotherapy in normalizing Caspase-3, Pax3, and Nrf2 levels.

Cite This Study

Shammary et al. (2026) studied this question.

synapsesocial.com/papers/6aa7b3bf0926e14a848b2e71 https://doi.org/10.24200/jogcr.11.11.1069

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Implication

Randomized controlled animal study demonstrates reduced fetal malformations with combined insulin-metformin therapy in diabetic rats, suggesting complementary protective mechanisms.

Embryotoxicity and Teratogenicity of Streptozotocin-Induced Insulin-Deficient Maternal Diabetes in Sprague-Dawley Rats: A Comparative Evaluation of Insulin Glargine, Metformin, and Combined Therapy

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Cite This Study

Embryotoxicity and Teratogenicity of Streptozotocin-Induced Insulin-Deficient Maternal Diabetes in Sprague-Dawley Rats: A Comparative Evaluation of Insulin Glargine, Metformin, and Combined Therapy

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