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Metformin, glyburide suitable for gestational diabetes treatment
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Management of gestational diabetes can be achieved with both metformin and glyburide, according to recent study findings published in The Journal of Clinical Endocrinology & Metabolism.
However, an increased risk for neonatal hypoglycemia, high maternal weight gain, high neonatal birth weight and macrosomia were associated with glyburide treatment, according to the researchers.
Zhong-Ning Zhu, PhD, of Hebei Medical University in China, and colleagues conducted a network meta-analysis of 18 randomized clinical trials to determine the efficacy and safety of oral antidiabetic drugs for the treatment of gestational diabetes.
No significant differences were found between oral antidiabetic drugs and insulin or between metformin and glyburide for fasting blood glucose or HbA1c through traditional meta-analyses and network meta-analyses. Similarly, no statistically significant differences were found between groups for cesarean delivery, preeclampsia or admission to the neonatal ICU for both analyses types.
The traditional meta-analysis revealed that compared with insulin, lower maternal weight gain (P = .01), shorter gestational age (P = .02) and increased risk for premature birth (P = .02) were associated with metformin. Also compared with insulin, glyburide was associated with higher neonatal birth weight (P = .0006), increased incidence of neonatal hypoglycemia (OR = 2.64; 95% CI, 1.59-4.38) and increased incidence of macrosomia (OR = 3.09; 95% CI, 1.59-6.04).
Compared with metformin, glyburide was associated with higher maternal weight gain, higher neonatal birth weight, increased rate of neonatal hypoglycemia and increased rate of macrosomia through network meta-analyses.
“In conclusion, both metformin and glyburide are suitable for use in management of [gestational diabetes] because of good glycemic control,” the researchers wrote. “However, glyburide treatment is associated with increased risk of neonatal hypoglycemia, high maternal weight gain, high neonatal birth weight and macrosomia.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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