Comparative Study between Acarbose and Insulin in the Treatment of GDM

Abstract

Background: GDM is a condition with predominantly high post prandial blood sugar levels. If left untreated it causes adverse maternal and perinatal outcome. Moreover in the long term most of the GDM mothers become diabetics. Aim: To compare the effectiveness of acarbose and insulin in the treatment of GDM. Methods: A randomized controlled trial was conducted. All antenatal women attending antenatal OPD were screened for GDM using DIPSI guidelines. Medical nutritional therapy was initiated in all screen positive individuals. Glycemic profile was done after two weeks. The individuals with abnormal glycemic profile and who met the inclusion criteria were included in the study. Results: The subjects in both the groups were matched for age, parity and BMI. The average gestational age at which screening was positive was 26 weeks of pregnancy. It was found that that Acarbose is equally effective as insulin in controlling the maternal blood sugar and in turn HbA1C. Obstetric outcomes like mode of delivery, Amniotic Fluid index, fetal growth were comparable in both groups. Fetal outcomes like birth weight, cord blood insulin, Respiratory distress and hypoglycaemia were also comparable in both groups. Conclusion: Hence, acarbose is a drug with same maternal and neonatal outcomes as insulin but has a better compliance than insulin.