Researchers at the University of Alabama at Birmingham have received an $8 million federal grant to examine how children fare over the long term when their mothers took metformin during pregnancy to manage Type 2 diabetes. The funding comes from the National Institute of Diabetes and Digestive and Kidney Diseases and builds on an earlier clinical trial focused on diabetes treatment during pregnancy.
Background and Study Origins
The new grant expands the scope of the MOMPOD trial — Medical Optimization and Management of Pregnancies with Overt Type 2 Diabetes — which set out to identify the most effective medication regimen for pregnant patients diagnosed with Type 2 diabetes. While insulin has long been the standard first-line treatment for this population, metformin has drawn interest as a potential addition to that therapy.
A key distinction between the two drugs is how they interact with pregnancy: insulin does not cross the placenta, while metformin does, meaning the developing fetus is directly exposed to metformin when the mother takes it. That biological difference is central to the questions the new study aims to answer.
“Pregnant women with Type 2 diabetes are at an increasingly high risk of maternal and infant complications,” said Ashley Battarbee, M.D., one of the researchers involved in the project.
What Earlier Research Found
Prior work from the MOMPOD trial produced a mixed picture. Adding metformin to insulin did not reduce the overall rate of neonatal complications such as preterm birth or newborn low blood sugar. However, the combination did lower the likelihood of delivering a large-for-gestational-age infant — a condition that raises the risk of cesarean delivery, birth trauma, and infant hypoglycemia.
A handful of smaller studies have since raised questions about whether metformin exposure in the womb may affect children’s body composition later in life. Paula Chandler-Laney, Ph.D., described the concern driving the expanded research: “The parent study showed not much benefit from adding metformin, and there are a few small studies with data showing that children of women given metformin have more body fat.”
How the Study Will Work
The new research will follow children to age 10 and measure a range of health outcomes tied to obesity risk and cardiometabolic health. Researchers will track body mass index, excess body fat, cholesterol levels, blood glucose, and blood pressure across a broad national sample.
Data collection will take place at 17 centers across the country, giving the study the scale needed to detect meaningful differences between children exposed to metformin in utero and those who were not. Participants will use continuous glucose monitors, and surveys will gather information on diet, physical activity, and environmental influences that could also shape health outcomes.
Why This Matters for MAHA Priorities
The study sits squarely within the broader MAHA focus on understanding how early-life exposures — including pharmaceutical ones — shape chronic disease trajectories in children. The question of whether a drug that crosses the placenta influences a child’s later risk of obesity or metabolic dysfunction reflects the kind of long-horizon thinking the movement has pushed federal health agencies to prioritize.
For Idaho families, the research echoes concerns raised closer to home. The University of Idaho recently secured an $11 million NIH grant to establish a women’s health nutrition center, another sign that federally funded researchers are increasingly focused on how maternal health decisions ripple forward into children’s lives.
Type 2 diabetes in pregnancy is not a rare edge case — it is a growing clinical challenge nationwide. As rates of metabolic disease rise, understanding which treatments serve both mother and child across decades, not just at delivery, is a question with real consequences for the next generation’s health. The UAB team expects its findings to help clinicians make more informed decisions about diabetes management during pregnancy once the longitudinal data matures.