A prospective study comparing insulin and glibenclamide in gestational diabetes mellitus in Asian Indian women

Chandrasekar, Anjalakshi; Balaji, Vijayam; Balaji, Madhuri S.; Seshiah, V.

doi:10.1016/j.diabres.2006.09.031

Cited by 88 publications

(77 citation statements)

References 2 publications

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“…Consistent with previous studies which showed that glyburide was effective on postprandial glycaemic control [17] [18]; seven studies [11]- [16] showed no significant difference between patients treated with insulin and those treated with glyburide (Figures 4(a)-(c)). …”

Section: Discussionsupporting

confidence: 80%

The Effectiveness of Glyburide Compared to Insulin in the Management of Gestational Diabetes Mellitus: A Systematic Review

Odiba¹,

Mabhala²

2015

JDM

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Background: Insulin therapy has been the mainstay in managing women with gestational diabetes mellitus (GDM), but some disadvantages of insulin have led to the use of glyburide, which is inexpensive in some countries, to manage GDM. However, there has been debate over its effectiveness, efficacy and safety when compared to insulin for maternal glycaemic control, and some adverse neonatal outcomes in GDM. Method: A systematic review of eight randomised controlled trial (RCT) studies was undertaken to compare glyburide and insulin. Studies involving 849 participants were included in the quantitative analysis. Results: There was no significant difference between glyburide and insulin in maternal fasting (P = 0.09; SMD: 0.13; 95% CI: −0.02 to 0.28) and postprandial (P = 0.45; SMD: 0.05; 95% CI: −0.09 to 0.19) glycaemic control and glycosylated haemoglobin (P = 0.35; SMD: 0.08; 95% CI: −0.08 to 0.24). When compared with insulin, glyburide had an increase risk ratio (RR) for neonatal hypoglycaemia (P = 0.0002; RR: 2.27; 95% CI: 1.47 to 3.51) and large for gestational age babies (P = 0.03; RR: 1.60; 95% CI: 1.06 to 2.41). Estimation of standard mean difference shows that neonatal birth weight was significantly higher in subjects receiving glyburide than in the insulin group (P = 0.002; SMD: 0.21; 95% CI: 0.08 to 0.35). Conclusions: Glyburide was seen to be clinically effective and a safer alternative to insulin for maternal glycaemic control in GDM women. It is affordable, convenient and requires no comprehensive educative training at the time of initiation of therapy. However, its adverse outcomes-neonatal hypoglycaemia, high neonatal birth weight and large for gestational age babies-call for careful monitoring of GDM patients for any need for supplemental insulin.

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Section: Discussionsupporting

confidence: 80%

The Effectiveness of Glyburide Compared to Insulin in the Management of Gestational Diabetes Mellitus: A Systematic Review

Odiba¹,

Mabhala²

2015

JDM

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“…The neonatal outcomes included neonatal hypoglycemia, macrosomia, congenital anomalies [15,[42][43][44]. Among them the largest trial was by Langer et al that included 404 women who were randomly assigned to insulin and glyburide.…”

Section: Insulin and Glyburidementioning

confidence: 99%

Oral Hypoglycemic Agents in pregnancy: An Update

Kavitha

Kanagasabai

2013

J Obstet Gynecol India

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Introduction Traditionally, insulin has been the gold standard in the management of Type 2 diabetes in pregnancy and gestational diabetes. However, insulin therapy can be inconvenient because of the needs for multiple injections, its associated cost, pain at the injection site, need for refrigeration, and skillful handling of the syringes. This has led to the exploration of oral hypoglycemic agents as an alternative to insulin therapy. Objectives This review examines and evaluates the evidences on the efficacy, safety, and current recommendations of oral hypoglycemic agents. Conclusion The evidence of this study supports the use of glyburide and metformin in the management of Type 2 diabetes and gestational diabetes with no increased risk of neonatal hypoglycemia or congenital anomalies. The safety of these oral hypoglycemic agents are limited to the prenatal period and more randomized controlled trials are required to provide information on the long-term follow up on neonatal and cognitive development.

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“…4 Anjalakshi et al concluded that insulin is expensive and many women find it inconvenient to take insulin. 5 Mukhopadhyay Partha et al concluded that the use of oral agents is a pragmatic alternative to insulin therapy in cases of gestational diabetes because of similar glycaemic control, ease of administration and better patient compliance due to non-invasive treatment. 6 Temple et al recently conducted over Indian population from a Department of OBG of a teaching hospital and reported that 93.8% and 97.1% of patients in glibenclamide and insulin groups obtained adequate glycaemic control respectively.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of using glibenclamide versus insulin in the treatment of gestational diabetes mellitus and its outcome

Rao

Datta

Prajwal

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Gestational diabetes mellitus(GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. This study aims at determining the efficacy of the glibenclamide versus insulin in achieving the adequate glycemic control and to analyze the maternal and fetal outcomes and to determine the failure rate of glibenclamide, patient compliance and overall cost of the treatmentMethods: This study was carried out for a period of 22 months at Command Hospital Air Force, Bangalore in Dept. of OBG. Women with GDM whose glycemic control was not achieved with medical nutrition therapy with fasting blood sugar (FBS) values >105mg/dl and 2hour post prandial blood sugar (PP) value >140mg/dl were selected and randomized for treatment either glibenclamide or insulin (50 in each group).Results: The age of the patients in this study ranged from 23 to 33 years. The mean age in glibenclamide group was 27.32 (SD ± 2.84) where as in insulin group was 26.30 (SD ± 3.01). The mean plasma glucose level achieved with glibenclamide was fasting -87.62 mg/dl, post prandial -116.44 mg/dl, before lunch - 95.62mg/dl, after lunch -115.80 mg/dl, before dinner-91.96 mg/dl, after dinner - 116.64 mg/dl, 3AM - 84.42 mg/dl and next day fasting - 86.30mg/dl in comparison with insulin where fasting- 85.54 mg/dl , post prandial -114.14 mg/dl, before lunch - 87.08, after lunch -112.82 mg/dl, before dinner-86.76 mg/dl and after dinner - 114.18 mg/dl, 3AM - 81.16 mg/dl and next day fasting was 86.72mg/dl which is statistically significant. The incidence of maternal and neonatal morbidities was comparable in both the group. 4 % percent of patient treated with glibenclamide had treatment failure. The cost of the treatment and compliance was better with glibenclamide.Conclusions: It has been concluded that glibenclamide is effective as insulin in achieving adequate glycemic control with no significant maternal and fetal morbidity and mortality.

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A prospective study comparing insulin and glibenclamide in gestational diabetes mellitus in Asian Indian women

Cited by 88 publications

References 2 publications

The Effectiveness of Glyburide Compared to Insulin in the Management of Gestational Diabetes Mellitus: A Systematic Review

The Effectiveness of Glyburide Compared to Insulin in the Management of Gestational Diabetes Mellitus: A Systematic Review

Oral Hypoglycemic Agents in pregnancy: An Update

A comparative study of using glibenclamide versus insulin in the treatment of gestational diabetes mellitus and its outcome

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