Glycemic control and neonatal outcomes in women with gestational diabetes mellitus treated using glyburide, metformin, or insulin: a pairwise and network meta-analysis

Abstract Aims We aimed to assess the comparative efficiency and safety of the use of glyburide, metformin, and insulin in gestational diabetes mellitus (GDM). Methods We searched for randomized controlled trials that compared glyburide, metformin, and insulin in GDM. Data regarding glycemic control and neonatal safety were collected and analyzed in pairwise and network meta-analyses. Results A total of 4533 individuals from 23 trials were included. Compared with glyburide, metformin reduced 2-h postprandial blood glucose (2HPG) to a greater extent (standard mean difference (SMD) 0.18; 95% credible interval (CI) 0.01, 0.34). There were significantly lower prevalence of neonatal hypoglycemia (risk difference (RD) − 0.07; 95%CI − 0.11, − 0.02) and preeclampsia (RD − 0.03; 95%CI − 0.06, 0) in the metformin group than in the insulin group. The metformin group had significantly lower birth weight (SMD − 0.17; 95%CI − 0.25, − 0.08) and maternal weight gain (SMD − 0.61; 95%CI − 0.86,− 0.35) compared with the insulin group. Network meta-analysis suggested that metformin had the highest probability of successfully controlling glycemia and preventing neonatal complications. Conclusions The present meta-analysis suggests that metformin may be as effective as insulin for glycemic control and is the most promising drug for the prevention of neonatal and maternal complications.

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Glycemic Control and Neonatal Outcomes in Women With Gestational Diabetes Mellitus Treated Using Glyburide, Metformin, or Insulin: A Pairwise and Network Meta-Analysis

10.21203/rs.3.rs-146509/v1 ◽

2021 ◽

Author(s):

Dan-Qing Yu ◽

Guan-Xin Xu ◽

Xin-Yuan Teng ◽

Jing-Wei Xu ◽

Liang-Fang Tang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Glycemic Control ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Meta Analysis ◽

Postprandial Blood Glucose ◽

Maternal Weight ◽

Insulin Group ◽

Standard Mean Difference ◽

Metformin Group

Abstract Aims: We aimed to assess the comparative efficiency and safety of the use of glyburide, metformin, and insulin in gestational diabetes mellitus (GDM).Methods: We searched for randomized controlled trials that compared glyburide, metformin, and insulin in GDM. Data regarding glycemic control and neonatal safety were collected and analyzed in pairwise and network meta-analyses.Results: A total of 4,683 individuals from 24 trials were included. Compared with glyburide, metformin reduced 2-hour postprandial blood glucose (2HPG) to a greater extent (standard mean difference (SMD) 0.18; 95% credible interval (CI) 0–0.36). There were significantly lower prevalences of neonatal hypoglycemia (risk difference (RD) −0.07; 95%CI−0.11–−0.03), neonatal intensive care unit (NICU) admission (RD−0.03; 95%CI−0.06–−0), and preeclampsia (RD−0.03; 95%CI−0.06–−0) in the metformin group than in the insulin group. The metformin group had significantly lower birth weight (SMD−0.25; 95%CI−0.41–−0.10) and maternal weight gain (SMD−0.61; 95%CI−0.86–−0.35) compared with the insulin group. Network meta-analysis suggested that metformin had the highest probability of successfully controlling glycemia and preventing neonatal complications.Conclusions: The present meta-analysis suggests that metformin may be as effective as insulin for glycemic control and is the most promising drug for the prevention of neonatal and maternal complications.

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The effect of probiotics on glycemic control and birth weight in gestational diabetes mellitus: meta-analysis

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2021.11.232 ◽

2022 ◽

Vol 226 (1) ◽

pp. S131-S132

Author(s):

Enav Yefet ◽

Liron Bar ◽

Rula Iskander ◽

Zohar Nachum

Keyword(s):

Diabetes Mellitus ◽

Birth Weight ◽

Glycemic Control ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Meta Analysis

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The effects of vitamin D supplementation on glycemic control and maternal-neonatal outcomes in women with established gestational diabetes mellitus: A systematic review and meta-analysis

Clinical Nutrition ◽

10.1016/j.clnu.2020.12.016 ◽

2020 ◽

Author(s):

Mengmeng Wang ◽

Zhaojing Chen ◽

Yan Hu ◽

Ying Wang ◽

Yinyin Wu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Vitamin D ◽

Glycemic Control ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Meta Analysis ◽

Vitamin D Supplementation ◽

Neonatal Outcomes

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Investigation the Effects of Metformin versus Insulin on Neonatal and Maternal Outcomes in Women with Gestational Diabetes Mellitus: A Randomized Clinical Trail

Global Journal of Health Science ◽

10.5539/gjhs.v9n4p272 ◽

2016 ◽

Vol 9 (4) ◽

pp. 272 ◽

Cited By ~ 2

Author(s):

Mahin Najafian ◽

Mojgan Barati ◽

Sara Masihi ◽

Ailin Fardipor

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Neonatal Outcomes ◽

Neonatal Hypoglycemia ◽

Singleton Pregnancy ◽

Insulin Group ◽

Metformin Group ◽

Maternal And Neonatal Outcomes ◽

The Mean

The aim of this study was to evaluate the effectiveness of metformin versus insulin in the glycemic control and to investigate the maternal and neonatal outcomes in in women with gestational diabetes mellitus. Pregnant women with gestational diabetes were randomized to either receive metformin (n=70) or insulin (n=70). Inclusion criteria were singleton pregnancy, following healthy diet and performing exercise for at least one week without satisfactory blood glucose level, no risk factor contributing to lactic acidosis, and no anatomic and/or chromosome anomalies. Two patients were excluded from the study due to lost to follow-up. The mean score of BMI and FBS after treatment was similar between two groups. But, the mean score of 2 hours blood sugar in insulin group (104.38±7.06 mg/dl) was significantly higher than metformin group (97.5±5.98 mg/dl) (P<0.0001). The weight gain in metformin group was slightly lower than insulin group. (P=0.123). The proportion of neonatal hypoglycemia in insulin group was higher than metformin group (20 vs 3, P=0.002). Other neonatal outcomes such as IUGR, IUFD, fetal anomaly, polyhydramnios, macrosomia, oligohydramnios, and NICU stay did not differ significantly between two groups. In conclusion, metformin had compatible effect with insulin in decreasing adverse maternal and neonatal outcomes even in some parameters such as neonatal hypoglycemia it works better. Totally, metformin is safe and effectiveness in controlling the gestational diabetes mellitus.

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Effectiveness of physical activity interventions on preventing gestational diabetes mellitus and excessive maternal weight gain: a meta-analysis

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.13429 ◽

2015 ◽

Vol 122 (9) ◽

pp. 1167-1174 ◽

Cited By ~ 81

Author(s):

G Sanabria-Martínez ◽

A García-Hermoso ◽

R Poyatos-León ◽

C Álvarez-Bueno ◽

M Sánchez-López ◽

...

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Weight Gain ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Meta Analysis ◽

Maternal Weight Gain ◽

Maternal Weight ◽

Physical Activity Interventions

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The effects of vitamin and mineral supplementation on women with gestational diabetes mellitus

BMC Endocrine Disorders ◽

10.1186/s12902-021-00712-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Dandan Li ◽

Zixin Cai ◽

Zhenhong Pan ◽

Yan Yang ◽

Jingjing Zhang

Keyword(s):

Oxidative Stress ◽

Diabetes Mellitus ◽

Glycemic Control ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Meta Analysis ◽

Cochrane Library ◽

Mineral Supplementation ◽

Vitamin And Mineral Supplementation ◽

And Oxidative Stress

Abstract Background The effects of vitamin and mineral supplementation on women with gestational diabetes mellitus (GDM) have not been well established. We conduct a meta-analysis to evaluate the effects of vitamin and mineral supplementation on glycemic control, inflammation and oxidative stress for women with GDM. Methods A systematic search of randomized controlled trials (RCTs) was conducted from PubMed, Embase, Web of Science and Cochrane Library up to July, 2020. Various results were pooled by using Review manager 5.3 and Stata 12.0. Mean difference (MD) with 95% confidence interval (CI) was estimated. Heterogeneity between studies was assessed by I-squared (I2) tests. Results Six hundred ninety-eight patients from 12 trials were included in our meta-analysis. Magnesium, zinc, selenium, calcium, vitamin D and E (alone or in combination) were found to significantly improve glycemic control in women with GDM compared to those receiving placebos: fasting plasma glucose (FPG) (MD = - 9.02; 95% CI: - 12.09, - 5.96; P < 0.00001), serum insulin (MD = - 4.33; 95% CI: - 5.35, - 3.32; P < 0.00001), homeostasis model assessment-insulin resistance (HOMA-IR) (MD = - 1.34; 95% CI: - 1.60, - 1.07; P < 0.00001), and homeostasis model of assessment for β cell function (HOMA-B) (MD = - 15.58; 95% CI: - 23.70, - 7.46; P = 0.0002). Vitamin and mineral supplementation was found to attenuated inflammation and oxidative stress through decreasing high-sensitivity C-reactive protein (hs-CRP) (MD = - 1.29; 95% CI: - 1.82, - 0.76; P < 0.00001), malondialdehyde (MDA) (MD = - 0.71; 95% CI: - 0.97, - 0.45; P < 0.00001), and increasing total antioxidant capacity (TAC) (MD = 45.55; 95% CI: 22.02, 69.08; P = 0.0001). Conclusions This meta-analysis shows that vitamin and mineral supplementation significantly improved glycemic control, attenuated inflammation and oxidative stress in women with GDM.

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GESTATIONAL DIABETES MELLITUS;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.01.2593 ◽

2019 ◽

Vol 26 (01) ◽

Author(s):

Khiaynat Sarwar Hashmi ◽

Tasneem Akhtar ◽

Sidrah Batool ◽

Kokab Saleem

Keyword(s):

Diabetes Mellitus ◽

Weight Gain ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Blood Sugar ◽

Neonatal Outcome ◽

Regular Insulin ◽

Insulin Group ◽

Metformin Group ◽

Number Of Patients

Objectives: To Compare metformin and regular insulin in blood sugar control and neonatal outcome in patients with gestational diabetes mellitus. Material and Method:… Study Design: Randomized control trial. Place of the Study: Department of Gynecology and Obstetrics, Bahawal Victoria hospital Bahawalpur. Duration of the study.1 year 1st January 2017- 31st December 2017. Sample Size: N=200, one half (group A) receiving Metformin and other half (group B) receiving regular insulin. Results: Blood sugar control depicted by fasting, 2 hr post parandial levels and HbA1c % was similar in both group.coexisting hypertensive complications were seen more in insulin group. Weight gain was also significantly more in insulin group 17 kg on an average as compared to metformin group where average weight gain was 13 kg.Convenience and satisfaction regarding their treatment,more number of patients were satisfied in metformin group. There were signiﬁcant increase in the mean birth weight of the newborns, need for admission in NICU and Neonatal hypoglycemia in insulin group as compared to metformin group. Conclusion: Metformin when compared to insulin has equal efficacy in controlling maternal blood sugar levels but better neonatal outcome, patient satisfaction and convenience in treatment of gestational Diabetes Mellitus.

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