The use of glyburide in the management of gestational diabetes mellitus: A meta-analysis

Glyburide has been used for managing gestational diabetes mellitus (GDM) in a number of countries. It is rather inexpensive. However, its efficacy and safety remain controversial. With this meta-analysis, we evaluated glyburide in comparison with insulin. With a systematic literature search strategy...

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Bibliographic Details
Published in:Advances in medical sciences 2014-03, Vol.59 (1), p.95-101
Main Authors: Zeng, Ya-chang, Li, Mu-jun, Chen, Yue, Jiang, Li, Wang, Su-mei, Mo, Xiao-liang, Li, Bin-yi
Format: Article
Language:English
Subjects:
Birth Weight
Blood Glucose - analysis
Diabetes, Gestational - drug therapy
Female
Gestational diabetes mellitus
Glyburide
Glyburide - therapeutic use
Humans
Hypoglycemic Agents - therapeutic use
Infant, Newborn
Insulin
Insulin - therapeutic use
Meta-analysis
Pregnancy
Randomized Controlled Trials as Topic
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Summary:Glyburide has been used for managing gestational diabetes mellitus (GDM) in a number of countries. It is rather inexpensive. However, its efficacy and safety remain controversial. With this meta-analysis, we evaluated glyburide in comparison with insulin. With a systematic literature search strategy, a total of 93 randomized controlled trials (RCTs) with insulin and glyburide comparison were identified. Based on the revised Consolidated Standards of Reporting Trials (CONSORT) checklist, five of them met the inclusion criteria and were included in this meta-analysis. Six hundred and seventy four subjects were included in these five RCTs. When compared with insulin, glyburide had an increased relative risk (RR) for neonatal hypoglycemia (RR: 1.98; 95% confidence interval [CI]: 1.17, 3.36). Estimation of standard mean differences (SMD) showed that both fetal birth weight and incidence of macrosomia were higher in subjects receiving glyburide than in those receiving insulin (SMD: 0.21; 95% CI: 0.06, 0.36; RR: 2.22; 95% CI: 1.07, 4.61 respectively). There were no significant differences in maternal glucose control, glycated hemoglobin, the rate of Cesarean section, large-for-gestational age, neonatal hypocalcemia, length of stay for neonatal ICU admissions, preterm birth, or congenital anomalies. Our study suggested that in women with GDM, glyburide is as effective as insulin, but the risks of neonatal hypoglycemia, high fetal birth weight, and macrosomia were higher.
ISSN:1896-1126
1898-4002
DOI:10.1016/j.advms.2014.03.001