Oral hypoglycemic agents = insulin in management of gestational diabetes

January 01, 0001

Oral hypoglycemic agents = insulin in management of gestational diabetes

The objective of this review by UK authors was to provide pooled estimates of randomized controlled trials comparing the effects of oral hypoglycemic agents with insulin in achieving glycemic control and to study the maternal and perinatal outcomes in gestational diabetes mellitus. All metaanalyses were performed using Stats Direct statistical software (Stats Direct Ltd, Cheshire, UK).

They found: "Six studies comprising 1388 subjects were analyzed. No significant differences were found in maternal fasting (weighted mean difference {WMD}, 1.31) or postprandial (WMD, 0.80) glycemic control. Use of oral hypoglycemic agents (OHAs) was not associated with risk of neonatal hypoglycemia (OR, 1.59), increased birthweight (WMD, 56.11), incidence of caesarean section (OR, 0.91), or incidence of large-for-gestational-age babies (OR, 1.01)."

The authors concluded: "Our study demonstrates that there are no differences in glycemic control or pregnancy outcomes when oral hypoglycemic agents were compared with insulin."

As both are acceptable most women will likely prefer pills to injections.

For the full abstract, click here.

Am J Obstet Gynecol 203(5):457.e1-457.e9, November 2010
© 2010 to Mosby, Inc.
Oral hypoglycemic agents vs insulin in management of gestational diabetes: a systematic review and metaanalysis. Jaya Saxena Dhulkotia, Bolarinde Ola, Robert Fraser, Tom Farrell. Correspondence to Dr. Dhulkotia: [email protected]

Category: W. Pregnancy, Childbirth, Family Planning, T. Endocrine/Metabolic/Nutritional. Keywords: gestational diabetes mellitus, insulin, oral hypoglycemic agents, meta-analysis of randomized controlled trials, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 7 December 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.