NCT07645001

Brief Summary

  1. 1.To compare the effects of metformin, insulin, and their combination with multistrain probiotics on glycemic control and insulin resistance in women with gestational diabetes mellitus (GDM), assessed by FPG, HbA1c, fasting insulin, and HOMA-IR.
  2. 2.To compare the effects of metformin, insulin, and their combination with multistrain probiotics on inflammatory biomarkers in women with GDM.
  3. 3.To determine the effect of multistrain probiotic supplementation alongside standard therapy on maternal and neonatal outcomes, including gestational age at delivery, mode of delivery, birth weight, Apgar score, and NICU admission.

Trial Health

63
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Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
200

participants targeted

Target at P75+ for not_applicable

Timeline
11mo left

Started Jul 2026

Geographic Reach
1 country

1 active site

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

June 8, 2026

Completed
4 days until next milestone

First Posted

Study publicly available on registry

June 12, 2026

Completed
19 days until next milestone

Study Start

First participant enrolled

July 1, 2026

Expected
11 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2027

Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2027

Last Updated

June 12, 2026

Status Verified

June 1, 2026

Enrollment Period

11 months

First QC Date

June 8, 2026

Last Update Submit

June 8, 2026

Conditions

Outcome Measures

Primary Outcomes (4)

  • Fasting blood glucose levels

    A fasting blood sugar level measures the amount of glucose in blood after patient has not eaten for at least 8 hours. It is primarily used to screen for or monitor prediabetes and diabetes. Fasting glucose is categorized as follows: Normal: Less than 100 mg/dL (5.6 mmol/L), Prediabetes: 100 to 125 mg/dL (5.6 to 6.9 mmol/L), Diabetes: 126 mg/dL (7.0 mmol/L) or higher on two separate tests.

    12 week

  • Fasting Serum Insulin Levels

    A serum fasting insulin test measures the amount of insulin in patient's blood after an overnight fast. It is used to evaluate pancreatic function, investigate hypoglycemia, and identify early-stage insulin resistance.Standard Lab Range: 2 to 25uIU/mL. Interpretation: High Levels (Hyperinsulinemia): Usually indicate insulin resistance, where cells do not respond properly to insulin, forcing the pancreas to produce excess amounts. It can precede prediabetes and Type 2 diabetes by years, even when blood sugar remains normal. Other causes include obesity, polycystic ovary syndrome (PCOS), and Cushing's syndrome.Low Levels: Suggest impaired or destroyed insulin-producing pancreatic beta cells. Common causes include Type 1 diabetes, chronic pancreatitis, or advanced Type 2 diabetes where the pancreas is "burned out"

    12 week

  • Homeostatic Model Assessment of Insulin Resistance

    It is a widely used medical tool that estimates how effectively your body regulates blood sugar. It acts as an indirect, highly accessible indicator of insulin resistance, helping assess the risk of type 2 diabetes and metabolic syndrome. Interpretation: Optimal / Sensitive: Under 1.0. Your body is highly sensitive to insulin and manages glucose well.Early Insulin Resistance: 1.0 to 2.9 (or greater than 1.9, depending on the diagnostic criteria). Your body is starting to require more insulin to keep blood sugar stable.Significant Insulin Resistance: Above 2.9 (or as low as 2.5 for some populations, particularly in Asian demographics)

    12 week

  • Glycated Hemoglobin

    Glycated hemoglobin (HbA1c) is a blood test that measures your average blood sugar levels over the past 2 to 3 months. It checks how much sugar has bonded to your hemoglobin, and is primarily used to diagnose prediabetes and diabetes, Below 5.7%: Normal / Healthy 5.7% to 6.4%: Prediabetes 6.5% or higher: Diabetes (diagnosed on two separate tests)

    12 week

Secondary Outcomes (11)

  • High-sensitivity C-reactive protein

    12 week

  • Neutrophil-to-Lymphocyte ratio

    12 week

  • Adiponectin

    12 week

  • fetal Abdominal Circumference

    12 week

  • thickness of placenta

    12 week

  • +6 more secondary outcomes

Study Arms (4)

GRP 1 Tab metformin

ACTIVE COMPARATOR
Other: GRP 1 Tab metformin

GRP 2 Inj insulin

ACTIVE COMPARATOR
Other: GRP 2 Inj insulin

GRP 3 Tab metformin + HI flora sachet

EXPERIMENTAL
Other: GRP 3 Tab metformin + HI flora sachet

GRP 4 Inj insulin + HI flora

EXPERIMENTAL
Other: GRP 4 Inj insulin + HI flora sachet

Interventions

Inj insulin s/c BD for 12 weeks

GRP 2 Inj insulin

Inj insulin s/c BD + HI flora sachet OD for 12 weeks

GRP 4 Inj insulin + HI flora

Tab metformin 500 mg TDS for 12 weeks

GRP 1 Tab metformin

Tab metformin 500 mg TDS + HI flora sachet OD for 12 weeks

GRP 3 Tab metformin + HI flora sachet

Eligibility Criteria

Age18 Years - 45 Years
Sexfemale(Gender-based eligibility)
Gender Eligibility Detailspregnant ladies
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Pregnant women (18-45 years of age).
  • Diagnosed with GDM between 18-26 weeks of gestation.

You may not qualify if:

  • Pre-existing diabetes mellitus.
  • Pregnancy induced hypertension.
  • Chronic gastrointestinal, hepatic, or renal disease.
  • Use of antibiotics or probiotics within the previous 4 weeks.
  • Multiple pregnancy.
  • Pregnancy with known fetal anomalies.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Pakistan Railway Hospital

Rawalpindi, Punjab Province, 46000, Pakistan

Location

MeSH Terms

Conditions

Diabetes, Gestational

Interventions

Metformin

Condition Hierarchy (Ancestors)

Pregnancy ComplicationsFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesDiabetes MellitusGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System Diseases

Intervention Hierarchy (Ancestors)

BiguanidesGuanidinesAmidinesOrganic Chemicals

Study Officials

  • Jawaria Iftikhar, phd*

    Riphah International University

    PRINCIPAL INVESTIGATOR
  • Akbar Waheed, PHD

    Riphah International University

    STUDY DIRECTOR

Central Study Contacts

Jawaria Iftikhar, phd*

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

June 8, 2026

First Posted

June 12, 2026

Study Start (Estimated)

July 1, 2026

Primary Completion (Estimated)

June 1, 2027

Study Completion (Estimated)

June 1, 2027

Last Updated

June 12, 2026

Record last verified: 2026-06

Data Sharing

IPD Sharing
Will not share

Locations