Web of Science: 208 cites, Scopus: 239 cites, Google Scholar: cites,
Glibenclamide, metformin, and insulin for the treatment of gestational diabetes : a systematic review and meta-analysis
Balsells, Montserrat (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
García Patterson, Apolonia (Institut d'Investigació Biomèdica Sant Pau)
Solà, Ivan (Institut d'Investigació Biomèdica Sant Pau)
Roqué, Marta (Institut d'Investigació Biomèdica Sant Pau)
Gich Saladich, Ignasi (Universitat Autònoma de Barcelona. Departament de Farmacologia, de Terapèutica i de Toxicologia)
Corcoy i Pla, Rosa (Universitat Autònoma de Barcelona. Departament de Medicina)
Universitat Autònoma de Barcelona

Data: 2015
Resum: Objective To summarize short term outcomes in randomized controlled trials comparing glibenclamide or metformin versus insulin or versus each other in women with gestational diabetes requiring drug treatment. Design Systematic review and meta-analysis. Eligibility criteria for selecting studies Randomized controlled trials that fulfilled all the following: (1) published as full text; (2) addressed women with gestational diabetes requiring drug treatment; (3) compared glibenclamide v insulin, metformin v insulin, or metformin v glibenclamide; and (4) provided information on maternal or fetal outcomes. Data sources Medline, CENTRAL, and Embase were searched up to 20 May 2014. Outcomes measures We considered 14 primary outcomes (6 maternal, 8 fetal) and 16 secondary (5 maternal, 11 fetal) outcomes. Results We analyzed 15 articles, including 2509 subjects. Significant differences for primary outcomes in glibenclamide v insulin were obtained in birth weight (mean difference 109 g (95% confidence interval 35. 9 to 181)), macrosomia (risk ratio 2. 62 (1. 35 to 5. 08)), and neonatal hypoglycaemia (risk ratio 2. 04 (1. 30 to 3. 20)). In metformin v insulin, significance was reached for maternal weight gain (mean difference −1. 14 kg (−2. 22 to −0. 06)), gestational age at delivery (mean difference −0. 16 weeks (−0. 30 to −0. 02)), and preterm birth (risk ratio 1. 50 (1. 04 to 2. 16)), with a trend for neonatal hypoglycaemia (risk ratio 0. 78 (0. 60 to 1. 01)). In metformin v glibenclamide, significance was reached for maternal weight gain (mean difference −2. 06 kg (−3. 98 to −0. 14)), birth weight (mean difference −209 g (−314 to −104)), macrosomia (risk ratio 0. 33 (0. 13 to 0. 81)), and large for gestational age newborn (risk ratio 0. 44 (0. 21 to 0. 92)). Four secondary outcomes were better for metformin in metformin v insulin, and one was worse for metformin in metformin v glibenclamide. Treatment failure was higher with metformin than with glibenclamide. Conclusions At short term, in women with gestational diabetes requiring drug treatment, glibenclamide is clearly inferior to both insulin and metformin, while metformin (plus insulin when required) performs slightly better than insulin. According to these results, glibenclamide should not be used for the treatment of women with gestational diabetes if insulin or metformin is available. Systematic review registration NCT01998113.
Drets: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. Creative Commons
Llengua: Anglès
Document: Article ; recerca ; Versió publicada
Publicat a: The BMJ, Vol. 350 (january 2015) , ISSN 1756-1833

DOI: 10.1136/bmj.h102
PMID: 25609400


12 p, 1.8 MB

El registre apareix a les col·leccions:
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació Biomèdica Sant Pau
Articles > Articles de recerca
Articles > Articles publicats

 Registre creat el 2018-01-31, darrera modificació el 2022-01-02



   Favorit i Compartir