Perinatal impact of the use of metformin and glyburide for the treatment of gestational diabetes mellitus
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Jean Carl Silva
,
Morgana Leonora Coral
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.
©2012 by Walter de Gruyter Berlin Boston
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Articles in the same Issue
- Review Article
- Retinal microvascular changes in low-birth-weight babies have a link to future health
- Original Articles – Obstetrics
- Chromosomal mosaicisms in prenatal diagnosis: correlation with first trimester screening and clinical outcome
- Perinatal impact of the use of metformin and glyburide for the treatment of gestational diabetes mellitus
- Incidence and causes of maternal thrombocytopenia in triplet gestation
- Maternal and paternal age and twinning in the United States, 2004–2008
- Correlates of the trend of cesarean section rates in twin pregnancies
- Prospective risk of stillbirth: monochorionic diamniotic twins vs. dichorionic twins
- Association between increased yolk sac diameter and abnormal karyotypes
- No “masculinization” effect of a male on birth weight of its female co-twin
- Comparison of risk calculation approaches in a screening programme for Down syndrome
- Individual decisions in placenta increta and percreta: a case series
- Original Articles – Fetus
- Fetal sex and perinatal outcomes
- Fetal magnetocardiography (fMCG): moving forward in the establishment of clinical reference data by advanced biomagnetic instrumentation and analysis
- Maternal and fetal cord blood lipids in intrauterine growth restriction
- Assessment of long-axis ventricular function in the fetal heart with a tissue-tracking algorithm
- Original Articles – Newborn
- A cluster of methicillin-sensitive Staphylococcus aureus colonization in a nursery
- Intermittent flushing improves cannula patency compared to continuous infusion for peripherally inserted venous catheters in newborns: results from a prospective observational study
- Opinion Paper
- Cross-over training in neonatology and obstetrics
- Congress Calender
- Congress Calendar
- Masthead
- Masthead
