Carolina de Freitas Alves Amaral-Moreira, Daiane Sofia de Morais Paulino, José Paulo Siqueira Guida, Belmiro Gonçalves Pereira, Patrícia Moretti Rehder, Fernanda Garanhani Surita
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引用次数: 0
Abstract
Objective: In this systematic review, we aim to compare the GWG in pregnant women with diabetes treated with metformin and other interventions.
Methods: Data Sources: The searched baselines included PubMed, Scopus, Web of Science, Embase, and Virtual Health Library (BVS). Study selection: We selected articles that compared the GWG in women with diabetes treated with metformin or insulin. We have included clinical trials (randomized or not), observational studies (cohort, case control, and cross-sectional). Reviews (systematic or not), posters, event abstracts, and letters were excluded. Data Collection: We pooled odds ratios (OR) and mean difference (MD) and used a random effect model using R Studio software to compare the weight gain, fetal birthweight and preeclampsia according to treatment.
Results: On research conducted in January 2024, with no data limit of the search, 433 trials were identified, of which 175 remained after duplicate removal. 50 studies were analyzed in the full text analyses and 9 were selected for the systematic review. 8 studies demonstrated that gestational weight gain during metformin treatment is lower when compared to other treatments, especially insulin, although it was not different from other outcomes. Meta-analyses demonstrated that oral medication GWG is lower than insulin with a standard mean difference (SMD) -1,05 [-1,87, - 0,23].
Conclusion: Oral medication has a lower gestational weight gain in patients with gestational diabetes when compared to insulin.
International prospective register of systematic reviews prospero: CRD 42024492158.
目的：在本系统综述中，我们旨在比较二甲双胍和其他干预措施治疗妊娠糖尿病妇女的GWG。方法：数据来源：检索的基线包括PubMed、Scopus、Web of Science、Embase和Virtual Health Library （BVS）。研究选择：我们选择了比较二甲双胍或胰岛素治疗的女性糖尿病患者GWG的文章。我们纳入了临床试验（随机或非随机）、观察性研究（队列、病例对照和横断面）。综述（系统的或非系统的）、海报、事件摘要和信件被排除在外。资料收集：采用R Studio软件合并优势比（OR）和平均差（MD），采用随机效应模型比较不同治疗组的体重增加、胎儿出生体重和子痫前期。结果：在2024年1月进行的研究中，没有检索数据限制，确定了433项试验，其中重复删除后保留了175项。在全文分析中分析了50项研究，并选择了9项进行系统评价。8项研究表明，与其他治疗方法，尤其是胰岛素治疗相比，二甲双胍治疗期间的妊娠体重增加较低，尽管与其他结果没有什么不同。meta分析显示，口服药物GWG低于胰岛素，标准均差（SMD）为-1,05[-1,87,- 0,23]。结论：与胰岛素相比，口服药物可降低妊娠期糖尿病患者的妊娠体重增加。国际前瞻性系统评价注册[j]: CRD 42024492158。
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