Metformin combined with insulin in women with gestational diabetes mellitus: a propensity score-matched study

Chaves, Catarina; Cunha, Filipe; Martinho, Mariana; Garrido, Susana; Silva-Vieira, Margarida; Estevinho, Catarina; Melo, Armindo; Figueiredo, Odete; Morgado, Ana; Almeida, M. C.; Almeida, Margarida

doi:10.1007/s00592-020-01665-8

Cited by 7 publications

(8 citation statements)

References 36 publications

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“…The Portuguese Gynecological Society uses the IADPSG criteria for screening and diagnosing GDM [ 109 ]. GDM prevalence was estimated at 3.4% in 2005, 6.7% in 2014, and 8.8% in 2018, which is 2.58-fold increase in frequency after changing the diagnostic guidelines for GDM.…”

Section: Europementioning

confidence: 99%

Evolution of Gestational Diabetes Mellitus across Continents in 21st Century

Dłuski

Ruszała

Rudziński

et al. 2022

IJERPH

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Over the last few decades, several definitions of gestational diabetes mellitus (GDM) have been described. There is currently not enough research to show which way is the best to diagnose GDM. Opinions differ in terms of the optimal screening and diagnostic measures, in part due to the differences in the population risks, the cost-effectiveness considerations, and the lack of an evidence base to support large national screening programs. The basic method for identifying the disease is the measurement of glucose plasma levels which may be determined when fasting, two hours after a meal, or simply at any random time. The currently increasing incidence of diabetes in the whole population, the altering demographics and the presence of lifestyle changes still require better methods of screening for hyperglycemia, especially during pregnancy. The main aim of this review is to focus on the prevalence and modifications to the screening criteria for GDM across all continents in the 21st century. We would like to show the differences in the above issues and correlate them with the geographical situation. Looking at the history of diabetes, we are sure that more than one evolution in GDM diagnosis will occur, due to the development of medicine, appearance of modern technologies, and the dynamic continuation of research.

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Section: Europementioning

confidence: 99%

Evolution of Gestational Diabetes Mellitus across Continents in 21st Century

Dłuski

Ruszała

Rudziński

et al. 2022

IJERPH

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“…Em contraposição a esses resultados, também são apresentados pontos negativos e malefícios dessa associação ou da seu uso isolado: maiores níveis de bilirrubina (Jiao et al, 2022), ganho de peso materno (Chaves et al, 2021& Yu et al, 2021, aumento do número de triglicerídeos, aumento da alanina sérica (Huhtala et al, 2021) e maiores taxas de parto cesáreo, considerando que separadamente as medicações não desempenharam associação ao aumento do número de cesárias em mulheres com DMG, mas quando associadas, a probabilidade cresceu de forma considerável (Pazzagli et al, 2020;Ramalho et al, 2022).…”

Section: Inglêsunclassified

“…Já Chaves et al (2021) refere dados contrários aos autores anteriores, de que o uso da metformina em gestantes com altos valores de glicemia em jejum, gerava um maior risco de falhar. Afirmando que quase 80% das pacientes tiveram que posteriormente incluir a insulina no tratamento para conseguir obter resultados glicêmicos satisfatórios.…”

Section: Inglêsunclassified

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Metformina frente a Diabetes Gestacional: existe eficácia?

Cabral¹,

Ferrer²,

Paula³

et al. 2023

RSD

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A Diabetes Mellitus Gestacional é uma patologia relacionada com o aumento da resistência à insulina e uma intolerância a glicose, com alterações na glicemia detectada pela primeira vez durante o período gestacional. Frente a essas situações são consideradas diversas terapêuticas, a insulina sendo considerada o padrão-ouro, mas com reconhecimento de novas opções que envolvam os fármacos orais, como a metformina. Objetivou-se discorrer sobre a eficácia do uso da metformina frente a diabetes gestacional. Trata-se de uma revisão integrativa da literatura, através de busca nas bases de dados MEDLINE, LILACS, via BVS e na SciELO, utilizando os Descritores em Ciências da Saúde: Gestação, Diabetes e Metformina, em associação ao operador booleano “AND”. Chegou-se à totalidade de 16 estudos para compor a revisão. O uso da metformina gerou resultados positivos, como o menor nível de colesterol total, ácido úrico e microalbuminúria, menores riscos de nascimento prematuro e do desenvolvimento de anomalias congênitas, auxiliou na glicemia pós-prandial, menor ganho de peso materno e evitou a hipoglicemia materna e neonatal. A eficácia geral é comprovada, entretanto ainda é um tema que carece de mais estudos, pois o mesmo também apresenta resultados negativos e pode ocasionar em complicações maternas e fetais, visto que a metformina é uma medicação que atravessa a placenta, o que pode levar a danos no feto.

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“…One final question could be certainly related to the eventual advantageous co-administration of metformin and insulin in GDM. Scarce reports have been published over the past decade; however, Chaves et al [44] recently addressed this issue through the retrospective investigation with an evaluation of the Portuguese National Registry of GDM (2012-2017) with a very interesting report that in GDM women the concomitant use of metformin and insulin resulted in comparable obstetric and neonatal adverse events if paralleled with insulin monotherapy. Moreover, the authors reported that expected beneficial effects on weight gain and insulin dose were simply not detected if both drugs were used in a parallel manner [44].…”

Section: Efficacy and Safetymentioning

confidence: 99%

Pharmacotherapy of Gestational Diabetes Mellitus: Current Recommendations

Radenković¹,

Jakovljevic²

2022

Gestational Diabetes Mellitus - New Developments

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The incidence of gestational diabetes mellitus (GDM) is still rising, and this pathological condition is strongly associated with some serious adverse pregnancy outcomes. Therefore, GDM must be timely recognized and adequately managed. Treatment of GDM is aimed to maintain normal glycemia and it should involve regular glucose monitoring, dietary modification, lifestyle changes, moderate physical activity, and pharmacotherapy, when necessary. As for the pharmacotherapy, needed in approximately one-third of GDM women, insulin administration is the first choice of pharmacological treatment, although oral hypoglycemic drugs, for example, metformin (a biguanide agent) or glyburide (a second-generation sulfonylurea drug), could be indicated, too. Metformin is considered as a reasonable and safe first-line alternative to insulin. If comparing two oral agents, metformin seems to be safer than glyburide, since glyburide was found to be linked to neonatal hypoglycemia and higher birth weight, which can for example increase the hazard for shoulder dystocia and a necessity for Cesarean delivery. Finally, it should be underlined that many pregnant women turn to complementary and alternative medicine for health maintenance or symptom relief, including traditional herbal medicine and the use of supplements. Given the previous facts, this chapter will address current pharmacotherapy options and challenges related to GDM treatment.

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Metformin combined with insulin in women with gestational diabetes mellitus: a propensity score-matched study

Cited by 7 publications

References 36 publications

Evolution of Gestational Diabetes Mellitus across Continents in 21st Century

Evolution of Gestational Diabetes Mellitus across Continents in 21st Century

Metformina frente a Diabetes Gestacional: existe eficácia?

Pharmacotherapy of Gestational Diabetes Mellitus: Current Recommendations

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