Lisa E Moore1, Diana Clokey, Valerie J Rappaport, Luis B Curet. 1. From the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico.
Abstract
OBJECTIVE: To compare the efficacy of metformin with glyburide for glycemic control in gestational diabetes. METHODS:Patients with gestational diabetes who did not achieve glycemic control on diet were randomly assigned to metformin (n=75) or glyburide (n=74) as single agents. The primary outcome was glycemic control. Secondary outcomes were drug failure rate and neonatal and obstetric complications. RESULTS: In the patients who achieved adequate glycemic control, the mean fasting and 2-hour postprandial blood glucose levels were not statistically different between the two groups. However, 26 patients in themetformin group (34.7%) and 12 patients in the glyburide group (16.2%) did not achieve adequate glycemic control and required insulin therapy (P=.01). CONCLUSION: In this study, the failure rate of metformin was 2.1 times higher than the failure rate of glyburide when used in the management of gestational diabetes (95% confidence interval 1.2-3.9). CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00965991. LEVEL OF EVIDENCE: I.
RCT Entities:
OBJECTIVE: To compare the efficacy of metformin with glyburide for glycemic control in gestational diabetes. METHODS:Patients with gestational diabetes who did not achieve glycemic control on diet were randomly assigned to metformin (n=75) or glyburide (n=74) as single agents. The primary outcome was glycemic control. Secondary outcomes were drug failure rate and neonatal and obstetric complications. RESULTS: In the patients who achieved adequate glycemic control, the mean fasting and 2-hour postprandial blood glucose levels were not statistically different between the two groups. However, 26 patients in the metformin group (34.7%) and 12 patients in the glyburide group (16.2%) did not achieve adequate glycemic control and required insulin therapy (P=.01). CONCLUSION: In this study, the failure rate of metformin was 2.1 times higher than the failure rate of glyburide when used in the management of gestational diabetes (95% confidence interval 1.2-3.9). CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00965991. LEVEL OF EVIDENCE: I.
Authors: Linda A Barbour; Christina Scifres; Amy M Valent; Jacob E Friedman; Thomas A Buchanan; Donald Coustan; Kjersti Aagaard; Kent L Thornburg; Patrick M Catalano; Henry L Galan; William W Hay; Antonio E Frias; Kartik Shankar; Rebecca A Simmons; Robert G Moses; David A Sacks; Mary R Loeken Journal: Am J Obstet Gynecol Date: 2018-06-28 Impact factor: 8.661
Authors: Diana L Shuster; Laura M Shireman; Xiaosu Ma; Danny D Shen; Shannon K Flood Nichols; Mahmoud S Ahmed; Shannon Clark; Steve Caritis; Raman Venkataramanan; David M Haas; Sara K Quinney; Laura S Haneline; Alan T Tita; Tracy A Manuck; Kenneth E Thummel; Linda Morris Brown; Zhaoxia Ren; Zane Brown; Thomas R Easterling; Mary F Hebert Journal: Clin Pharmacol Ther Date: 2020-01-25 Impact factor: 6.875