Comparison of Fetomaternal Outcomes in Patients With Gestational Diabetes Mellitus Treated With Insulin Versus Acarbose: Results of a Prospective, Open Label, Controlled Study

Abstract

To evaluate fetomaternal outcomes in patients with gestational diabetes mellitus (GDM) treated with insulin versus acarbose. Material and methodsIn this prospective, open label, controlled study, GDM patients treated with insulin or acarbose were observed till six weeks after delivery. Maternal outcomes, fetal outcomes and glycemic control were compared between two groups. ResultsFifty patients in each group (insulin group-mean age 28.52 years; acarbose group-mean age 26.26 years; p=0.020) were included. There was no difference in body mass index (p=0.157), family history of diabetes (p=0.648), history of GDM (p=0.50) or mean gestational age at diagnosis (p=0.245) between the two groups. There was no significant difference in the incidence of recurrent infections (p=0.64), pre-eclampsia (p=0.64) or premature rupture of membranes (p=0.40) between the two groups. Mean duration of gestational weeks at the time of delivery in the insulin and acarbose group was 36.93 and 38.36 weeks respectively (p=0.002). There was no difference in the modes of delivery, mean post-operative random blood glucose (p=0.96), fasting blood glucose level at day seven (p=0.15) and after six weeks (p=0.83) between the insulin and acarbose groups. There was no difference in reduction in the postprandial blood glucose level at day seven (p=0.48) and after six weeks (p=0.23). There was no significant difference in the mean birth weight of babies born to mothers treated with the two drugs (p=0.21). There was no difference in the incidence of neonatal complications between the two groups. ConclusionAcarbose can be an effective and well tolerated option for treatment of gestational diabetes mellitus.

Association between fasting plasma glucose variability and maternal and infant outcomes in patients with hyperglycemia during pregnancy: a retrospective cohort study

“…With increasing gestational age, insulin resistance also gradually increases. The rational application of hypoglycemic treatment can stabilize blood glucose levels in patients with hyperglycemia during pregnancy ( 34 ). However, the effects of different hypoglycemic regimens on blood GV and maternal and infant outcomes should be studied further.…”

Pharmacotherapy of Gestational Diabetes Mellitus: Current Recommendations

“…Although in this short trial, failure to achieve glycemic control with acarbose was higher if compared to glyburide, the decreased incidence of hypoglycemia and macrosomia underlines acarbose as an appealing agent to investigate in future GDM treatment studies. Accordingly, in the recent investigation published by Jayasingh et al (2020), it was proposed that acarbose can be seen as an effective and adequately tolerated choice for the management of GDM [56]. Namely, this prospective, open-label, and controlled study was designed to compare the fetomaternal outcomes in pregnant women with GDM designated to insulin or acarbose group.…”