Author:
Wang Ting,Jing Yingyu,Guo Haonan,Xu Jing,Wang Man,Huang Lili,Chen Huan,Cui Wei,Song Lin,Liu Xiang,Sun Bo,Wang Ning
Abstract
ObjectiveTo compare the efficacy and safety of metformin, glyburide, and insulin for GDM, we conducted a subgroup analysis of outcomes for women with GDM according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria.MethodsWe searched the NCBI, Embase, and Web of Science databases from inception to March 2022. Randomized controlled trials (RCTs) that compared the outcomes of hypoglycemic agents in women with GDM were included. Bayesian network analysis was employed.ResultsA total of 29 RCTs were included. Metformin was estimated to lead to a slight improvement in total gestational weight gain (WMD – 1.24 kg, 95% CI −2.38, −0.09), a risk of unmet treatment target in the sensitivity analysis (OR 34.50, 95% CI 1.18–791.37) than insulin. The estimated effect of metformin showed improvements in birth weight than insulin (WMD – 102.58 g, 95% CI −180.45 to −25.49) and glyburide (WMD – 137.84 g, 95% CI −255.31 to −25.45), for hypoglycemia within 1 h of birth than insulin (OR 0.65, 95% CI 0.47 to 0.84). The improvement in the estimated effect of metformin for hypoglycemia within 1 h of birth still existed when compared with glyburide (OR 0.41, 95% CI 0.26 to 0.66), whether in the IADPSG group (OR 0.33, 95% CI 0.12 to 0.92) or not (OR 0.43, 95% CI 0.20 to 0.98).ConclusionMetformin is beneficial for GDM women to control total GWG compared with insulin, regulate fetal birth weight more than insulin and glyburide, and increase the risk of unmet treatment targets compared with insulin. Compared to metformin, glyburide is associated with neonatal hypoglycemia.
Funder
Natural Science Foundation of Shaanxi Province
National Natural Science Foundation of China
Subject
Public Health, Environmental and Occupational Health
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献