Efficacy and safety of pharmacological treatments for gestational diabetes: a systematic review comparing metformin with glibenclamide and insulin

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism Pub Date : 2025-02-07 DOI:10.1016/j.diabet.2025.101622

Louise Bodier , Maela Le Lous , Hélène Isly , Christèle Derrien , Patricia Vaduva

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引用次数: 0

Abstract

Aim

Gestational diabetes, characterized by impaired glucose tolerance occurring or diagnosed during pregnancy, is a significant public health concern. When lifestyle and dietary measures fail (30 % of women), insulin is the standard treatment. Oral antidiabetic agents, such as metformin (Glucophage) and glibenclamide, could provide a promising alternative. The aim here was to evaluate the effectiveness and safety of these treatments in gestational diabetes.

Methods

This study is based on a systematic literature review. A keyword search for "metformin (Glucophage)," "glibenclamide," "pregnancy," and "gestational diabetes" was conducted in the PubMed and Google Scholar databases from 2013 to 2023.

Results

A total of 45 studies were selected and analyzed. metformin (Glucophage) appears to offer a combination of effectiveness in glycemic control and maternal and neonatal safety. Compared to insulin, it reduces maternal weight gain, lowers maternal hypoglycemia rates, and shows a tendency to reduce gestational hypertension and preeclampsia. Additionally, infants born to mothers on metformin (Glucophage) are less likely to be macrosomic, experience fewer neonatal hypoglycemic episodes, and require fewer admissions to intensive care units. On the other hand, glibenclamide seems effective in glycemic control but is associated with higher rates of macrosomia and neonatal hypoglycemia.

Conclusion

Metformin (Glucophage) appears to be a promising alternative to insulin for treating gestational diabetes, while uncertainties remain regarding the safety of glibenclamide.

查看原文本刊更多论文

妊娠期糖尿病药物治疗的有效性和安全性：二甲双胍与格列本脲和胰岛素比较的系统综述。

目的：妊娠期糖尿病是一个重大的公共卫生问题，其特征是在妊娠期间发生或诊断出糖耐量受损。当生活方式和饮食措施失败时（30%的女性），胰岛素是标准治疗。口服降糖药，如二甲双胍和格列本脲，可能是一个有希望的选择。目的是评估这些治疗方法在妊娠期糖尿病中的有效性和安全性。方法：本研究基于系统的文献回顾。从2013年到2023年，在PubMed和谷歌Scholar数据库中对“二甲双胍”、“格列本脲”、“妊娠”和“妊娠糖尿病”进行了关键词搜索。结果：共选取45项研究进行分析。二甲双胍似乎在血糖控制和母婴安全方面提供了有效的组合。与胰岛素相比，它可以减少产妇体重增加，降低产妇低血糖率，并有减少妊娠高血压和先兆子痫的倾向。此外，服用二甲双胍的母亲所生的婴儿不太可能是巨大的，经历较少的新生儿低血糖发作，并且需要较少的重症监护病房。另一方面，格列本脲在血糖控制方面似乎有效，但与巨大儿和新生儿低血糖的发生率较高有关。结论：二甲双胍似乎是治疗妊娠期糖尿病的有希望的胰岛素替代品，而关于格列本脲的安全性仍然存在不确定性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes & metabolism 医学-内分泌学与代谢

CiteScore

12.00

自引率

4.20%

发文量

审稿时长

13 days

期刊介绍： A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.