Background: Controlling diabetes mellitus (DM) in pregnancy is important to avoid further maternal and fetal complications. This can be achieved by diet regimen, exercise, insulin and oral hypoglycemic agent like metformin. We aimed to compare between basal bolus insulin regimen with metformin and flexible basal bolus regimen according to carbohydrate insulin ratio with metformin on control of blood sugar among pregnant women with diabetes.
Methods: Our study is a randomized controlled trial on 60 cases of pregnant women with diabetes who are attending Obstetrics and Gynecology department at Mansoura university hospitals. Cases were randomized into two groups: Group I (basal bolus regimen group) (n = 30) including women who received oral metformin in addition to insulin by the basal bolus insulin regimen; Group II (insulin carbohydrate regimen group) (n = 30) including women who received oral metformin in addition to insulin by insulin carbohydrate regimen.
Results: Our result showed that there was 100% control in fasting glucose levels and 100% control in post prandial glucose level in group 1 and 70% control in group 2.  Conclusion: the basal bolus regimen is better than insulin carbohydrate ratio in patient with diabetes who are at mid education level with carbohydrate counting.