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Perinatal outcomes and the use of oral hypoglycemic agents

Anna Maria Bertini1, Jean Carl Silva, Wladimir Taborda

  • 1Obstetrics Department, Federal University of São Paulo, Brazil.

Journal of Perinatal Medicine
|December 2, 2005
PubMed

Insights

Insulin, glyburide, and acarbose were compared for gestational diabetes mellitus (GDM) treatment. Glyburide showed better glucose control than acarbose but increased risks of large for gestational age infants and neonatal hypoglycemia.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Endocrinology

Background:

  • Gestational diabetes mellitus (GDM) requires effective management to prevent adverse neonatal outcomes.
  • Oral antihyperglycemic agents are increasingly considered as alternatives to insulin for GDM treatment.

Purpose of the Study:

  • To compare neonatal outcomes in GDM patients treated with insulin, glyburide, or acarbose.
  • To evaluate the efficacy and safety of glyburide and acarbose versus insulin in GDM management.

Main Methods:

  • A comparative study involving 70 GDM patients requiring pharmacologic therapy.
  • Patients were randomized into three groups: insulin (n=27), glyburide (n=24), and acarbose (n=19).
  • Neonatal outcomes including glucose control, birth weight, LGA, and hypoglycemia were assessed.

Main Results:

  • Glyburide achieved glucose control in 79.2% of patients, while acarbose achieved it in 57.9%.
  • No significant differences were found in fasting/post-prandial glucose or average newborn weight across groups.
  • The rate of large for gestational age (LGA) fetuses was higher with glyburide (25%) and acarbose (10.5%) compared to insulin (3.7%).
  • Neonatal hypoglycemia occurred in 6 of 8 newborns in the glyburide group.

Conclusions:

  • Glyburide and acarbose show potential as alternative GDM therapies.
  • Glyburide demonstrated superior glucose control compared to acarbose.
  • Glyburide use was associated with increased rates of macrosomia and neonatal hypoglycemia.
Abstract

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