Perinatal impact of the use of metformin and glyburide for the treatment of gestational diabetes mellitus

Perinatal impact of the use of metformin and glyburide for the treatment of gestational diabetes mellitus

Author Silva, Jean Carl Google Scholar
Rigon Narciso Fachin, Debora Raquel Google Scholar
Coral, Morgana Leonora Google Scholar
Bertini, Anna Maria Autor UNIFESP Google Scholar
Institution Univ Regiao Joinville UNIVILLE
Universidade Federal de São Paulo (UNIFESP)
Abstract Objective : To evaluate the perinatal impact of metformin and glyburide in the treatment of gestational diabetes mellitus (GDM).Methods : A randomized clinical trial conducted from July 2008 until September 2010 studied 200 pregnant women with GDM who required adjunctive therapy to diet and physical activity. Patients were randomized to use metformin (n = 104) or glyburide (n = 96). the drugs were replaced by insulin when they reached the maximum dose without glycemic control. Assessed outcomes: weight and neonatal blood glucose.Results : No difference was found (P > 0.05) between the groups regarding maternal age, gestational age at inclusion, body mass index, glucose levels in oral glucose tolerance test (OGTT) 75 g and glycemic control. Difference was found in the number of previous pregnancies (2.84 vs. 2.47, P = 0.04) and weight gain during pregnancy (7.78 vs. 9.84, P = 0.04) in the metformin group and glyburide respectively. the perinatal results showed no difference (P > 0.05) in the percentage of cesarean deliveries, gestational age at delivery, number of newborns large for gestational age (LGA), neonatal hypoglycemia, admission to intensive care unit and perinatal death. We found differences in weight (3193 g vs. 3387 g, P = 0.01) and ponderal index (2.87 vs. 2.96, P = 0.05) of newborns, and in neonatal blood glucose levels at the 1st (59.78 vs. 54.08, P = 0.01) and 3rd h (61.53 vs. 55.89, P = 0.01) after birth between the metformin and glyburide groups respectively.Conclusions : Weight and ponderal index were lower in the newborns of the metformin group; glucose levels (1st and 3rd h after birth) were lower in the glyburide group.
Keywords Body mass index
gestational age at delivery
gestational diabetes mellitus
glyburide
intensive care unit, large for gestational age
metformin
oral glucose tolerance test
Language English
Date 2012-04-01
Published in Journal of Perinatal Medicine. Berlin: Walter de Gruyter & Co, v. 40, n. 3, p. 225-228, 2012.
ISSN 0300-5577 (Sherpa/Romeo, impact factor)
Publisher Walter de Gruyter & Co
Extent 225-228
Origin http://dx.doi.org/10.1515/jpm-2011-0175
Access rights Closed access
Type Article
Web of Science ID WOS:000303977800003
URI http://repositorio.unifesp.br/handle/11600/34785

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