Comparison of glyburide and insulin in the management of gestational diabetes: A meta-analysis.

<h4>Objective</h4>The aim of this meta-analysis was to determine the efficacy and safety of glyburide as a treatment for gestational diabetes mellitus (GDM) compared to insulin.<h4>Methods</h4>A meta-analysis was conducted to compare the management of gestational diabetes wit...

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Main Authors: Rongjing Song, Ling Chen, Yue Chen, Xia Si, Yi Liu, Yue Liu, David M Irwin, Wanyu Feng
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182488&type=printable
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author Rongjing Song
Ling Chen
Yue Chen
Xia Si
Yi Liu
Yue Liu
David M Irwin
Wanyu Feng
author_facet Rongjing Song
Ling Chen
Yue Chen
Xia Si
Yi Liu
Yue Liu
David M Irwin
Wanyu Feng
author_sort Rongjing Song
collection DOAJ
description <h4>Objective</h4>The aim of this meta-analysis was to determine the efficacy and safety of glyburide as a treatment for gestational diabetes mellitus (GDM) compared to insulin.<h4>Methods</h4>A meta-analysis was conducted to compare the management of gestational diabetes with glyburide and insulin. Studies fulfilling all of the following inclusion criteria were included in this meta-analysis: subjects were women with gestational diabetes requiring drug treatment; the comparison treatment included glyburide vs insulin; one or more outcomes (maternal or neonatal) should be provided in the individual study; the study design should be a randomized control trial. Exclusion criteria: non-RCT studies; non-human data. PubMed, Embase and CENTRAL databases were searched from inception until 10 October 2016.<h4>Results</h4>Ten randomized control trials involving 1194 participants met the inclusion criteria and were included. 13 primary outcomes (6 maternal, 7 neonatal) and 26 secondary outcomes (9 maternal, 17 neonatal) were detected and analyzed in this study. Glyburide significantly increased the risk of any neonatal hypoglycemia [risk ratio (RR), 1.89; 95% confidence interval (95%CI), 1.26 to 2.82; p = 0.002]. Sensitivity analysis confirmed robustness of this result [RR, 2.29; 95%CI, 1.49 to 3.54; p = 0.0002]. No differences were observed between the two groups with respect to birth weights [mean difference (MD), 79; 95%CI, -64 to 221.99; p = 0.28] and the risk of macrosomia [RR, 1.69; 95%CI, 0.57 to 5.08; p = 0.35].<h4>Conclusion</h4>For women with gestational diabetes, no differences in maternal short term outcomes were observed in those treated with glyburide or insulin. However, the incidence of neonatal hypoglycemia was higher in the glyburide group compared to the insulin group.
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spelling doaj-art-93a893d102e747e3a39807b8cd32083a2025-08-20T02:03:59ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01128e018248810.1371/journal.pone.0182488Comparison of glyburide and insulin in the management of gestational diabetes: A meta-analysis.Rongjing SongLing ChenYue ChenXia SiYi LiuYue LiuDavid M IrwinWanyu Feng<h4>Objective</h4>The aim of this meta-analysis was to determine the efficacy and safety of glyburide as a treatment for gestational diabetes mellitus (GDM) compared to insulin.<h4>Methods</h4>A meta-analysis was conducted to compare the management of gestational diabetes with glyburide and insulin. Studies fulfilling all of the following inclusion criteria were included in this meta-analysis: subjects were women with gestational diabetes requiring drug treatment; the comparison treatment included glyburide vs insulin; one or more outcomes (maternal or neonatal) should be provided in the individual study; the study design should be a randomized control trial. Exclusion criteria: non-RCT studies; non-human data. PubMed, Embase and CENTRAL databases were searched from inception until 10 October 2016.<h4>Results</h4>Ten randomized control trials involving 1194 participants met the inclusion criteria and were included. 13 primary outcomes (6 maternal, 7 neonatal) and 26 secondary outcomes (9 maternal, 17 neonatal) were detected and analyzed in this study. Glyburide significantly increased the risk of any neonatal hypoglycemia [risk ratio (RR), 1.89; 95% confidence interval (95%CI), 1.26 to 2.82; p = 0.002]. Sensitivity analysis confirmed robustness of this result [RR, 2.29; 95%CI, 1.49 to 3.54; p = 0.0002]. No differences were observed between the two groups with respect to birth weights [mean difference (MD), 79; 95%CI, -64 to 221.99; p = 0.28] and the risk of macrosomia [RR, 1.69; 95%CI, 0.57 to 5.08; p = 0.35].<h4>Conclusion</h4>For women with gestational diabetes, no differences in maternal short term outcomes were observed in those treated with glyburide or insulin. However, the incidence of neonatal hypoglycemia was higher in the glyburide group compared to the insulin group.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182488&type=printable
spellingShingle Rongjing Song
Ling Chen
Yue Chen
Xia Si
Yi Liu
Yue Liu
David M Irwin
Wanyu Feng
Comparison of glyburide and insulin in the management of gestational diabetes: A meta-analysis.
PLoS ONE
title Comparison of glyburide and insulin in the management of gestational diabetes: A meta-analysis.
title_full Comparison of glyburide and insulin in the management of gestational diabetes: A meta-analysis.
title_fullStr Comparison of glyburide and insulin in the management of gestational diabetes: A meta-analysis.
title_full_unstemmed Comparison of glyburide and insulin in the management of gestational diabetes: A meta-analysis.
title_short Comparison of glyburide and insulin in the management of gestational diabetes: A meta-analysis.
title_sort comparison of glyburide and insulin in the management of gestational diabetes a meta analysis
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182488&type=printable
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