Benefits and Risks of Oral Diabetes Agents Compared With Insulin in Women With Gestational Diabetes: A Systematic Review

@article{Nicholson2009BenefitsAR,
  title={Benefits and Risks of Oral Diabetes Agents Compared With Insulin in Women With Gestational Diabetes: A Systematic Review},
  author={Wanda K. Nicholson and Shari D. Bolen and Catherine T. Witkop and Donna M. Neale and Lisa M Wilson and Eric B. Bass},
  journal={Obstetrics \& Gynecology},
  year={2009},
  volume={113},
  pages={193-205}
}
OBJECTIVE: Little is known about the comparative risks and benefits of medical treatments for gestational diabetes mellitus (GDM). We conducted a systematic review of randomized controlled trials and observational studies of maternal and neonatal outcomes in women with GDM treated with oral diabetes agents compared with all types of insulin. DATA SOURCES: We searched four electronic databases from inception through January 2007. Terms for GDM, insulins, and oral hypoglycemic agents were used in… Expand

Topics from this paper

Paper Mentions

Observational Clinical Trial
Since the publication in the New England Journal of Medicine (NEJM) in 2000 of the Langer's trial comparing glyburide vs insulin in the treatment of gestational diabetes mellitus (GDM… Expand
ConditionsGestational Diabetes Mellitus
InterventionDrug
Review: Oral drugs for gestational diabetes do not increase adverse maternal and neonatal outcomes more than insulin
  • D. Feig
  • Medicine
  • Annals of Internal Medicine
  • 2009
TLDR
The authors concluded that no substantial differences in outcomes were found and no increased risks of harm were associated with the use of these agents; therefore, the evidence supports use of oral agents in pregnancy. Expand
[Safety and effectiveness of oral hypoglycemic agents in women with gestational diabetes. Literature review].
TLDR
HGO provide adequate control of maternal glycemia and perinatal results comparable insulin therapy, and they should be considered as effective and safe option in the treatment of GDM. Expand
Oral hypoglycemic agents vs insulin in management of gestational diabetes: a systematic review and metaanalysis.
TLDR
This study demonstrates that there are no differences in glycemic control or pregnancy outcomes when OHAs were compared with insulin and to study the maternal and perinatal outcomes in gestational diabetes mellitus. Expand
Efficacy and Safety of Oral Antidiabetic Drugs in Comparison to Insulin in Treating Gestational Diabetes Mellitus: A Meta-Analysis
TLDR
The available evidence suggests favorable effects of metformin in treating GDM patients and Metformin seems to be an efficacious alternative to insulin and a better choice than glyburide especially those with mild form of disease. Expand
Metformin for the treatment of gestational diabetes: An updated meta-analysis.
TLDR
In women with gestational diabetes, metformin use and insulin therapy have comparable glycemic control profile, but metformIn use was associated with lower risk of neonatal hypoglycemia, and Bayesian analysis revealed that the efficacy of met formin was consistently higher than insulin with a probability of over 98% on these two neonatal complications. Expand
Assessment of Metformin Versus Insulin for the Treatment of Gestational Diabetes
TLDR
Oral meetformin therapy is an effective and safe treatment option for women with gestational diabetes who meet the criteria for starting insulin, and that metformin is more acceptable than insulin. Expand
Neonatal outcomes in women with gestational diabetes mellitus treated with metformin in compare with insulin: A randomized clinical trial
TLDR
Based on preliminary data, considering neonatal outcomes, metformin appears to be a safe as insulin in the treatment of GDM. Expand
Metformin compared with insulin in the management of gestational diabetes mellitus: a randomized clinical trial.
TLDR
Metformin is an effective and safe alternative treatment to insulin for women with GDM and does not show significant risk of maternal or neonatal adverse outcome with the use of metformin. Expand
Metformin is comparable to insulin for pharmacotherapy in gestational diabetes mellitus: A network meta-analysis evaluating 6046 women.
TLDR
Metformin is, at least, comparable to insulin for the treatment of GDM, and glibenclamide appears less favorable, in comparison to insulin, than metformin. Expand
Comparison of glyburide and insulin in the management of gestational diabetes: A meta-analysis
TLDR
For women with gestational diabetes, no differences in maternal short term outcomes were observed in those treated with glyburide or insulin, however, the incidence of neonatal hypoglycemia was higher in the glyBuride group compared to the insulin group. Expand
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